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Quantitative morphologic and functional evaluation of the optic nerve head in chronic open-angle glaucoma
K U Bartz-Schmidt1, G Thumann, C P Jonescu-Cuypers
1Department of Ophthalmology, University of Cologne, Germany. Ulrich.BartzSchmidt@unikoeln.de
Survey of Ophthalmology
|November 5, 1999
Summary
Morphologic changes in the optic nerve head are more prominent than visual field defects in early glaucoma. Functional tests become more sensitive than morphologic examinations in advanced glaucoma stages.
Area of Science:
- Ophthalmology
- Neuroscience
Background:
- Glaucoma causes optic nerve head morphologic changes and functional defects.
- Laser scanning tomography examines optic nerve head structure; static computerized perimetry assesses visual field function.
Purpose of the Study:
- Compare the sensitivity of laser scanning tomography and static computerized perimetry for monitoring glaucomatous optic nerve damage.
- Evaluate the relationship between morphologic and functional defects in glaucoma progression.
Main Methods:
- 90 chronic open-angle glaucoma patients, 10 ocular hypertension patients, and 10 controls underwent visual field testing and laser scanning tomography.
- Calculated relative rim area loss from the rim/disk area ratio and correlated it with mean visual field defect.
Main Results:
- Early glaucoma shows less prominent visual field defects than morphologic changes; 40% of neuroretinal rim area can be lost before visual field defects appear.
- In advanced glaucoma, functional changes detected by perimetry are more prominent than morphologic changes.
Conclusions:
- Morphologic changes are crucial for monitoring early-stage glaucoma.
- Functional examinations are more sensitive for tracking disease progression in advanced glaucoma.
- Technological sensitivity of diagnostic tools impacts early glaucoma detection.