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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Optic disc morphology in open-angle glaucoma compared with anterior ischemic optic neuropathies
Helen V Danesh-Meyer1, Michael V Boland, Peter J Savino
1New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand. h.daneshmeyer@auckland.ac.nz
Investigative Ophthalmology & Visual Science
|September 10, 2009
Summary
Open-angle glaucoma (OAG) shows distinct optic disc topography compared to nonarteritic anterior ischemic optic neuropathy (NAION) and arteritic anterior ischemic optic neuropathy (AAION), even with similar retinal ganglion cell loss.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
- Optic Nerve Diseases
Background:
- Optic disc topography is crucial for diagnosing optic neuropathies.
- Differentiating between open-angle glaucoma (OAG) and anterior ischemic optic neuropathies (AION) is clinically important.
- Retinal ganglion cell (RGC) loss is a common endpoint in these conditions, but the underlying disc changes may differ.
Purpose of the Study:
- To compare optic disc topography using confocal laser ophthalmoscopy in eyes with OAG, nonarteritic anterior ischemic optic neuropathy (NAION), and arteritic anterior ischemic optic neuropathy (AAION).
- To adjust for the degree of RGC loss, measured by nerve fiber layer (NFL) thickness and visual field mean deviation (MD).
Main Methods:
- Prospective study involving 103 patients with OAG, 53 with NAION, and 18 with AAION.
- Utilized Heidelberg Retinal Tomography (HRT), Stratus Optical Coherence Tomography (OCT), and Humphrey visual field testing (HFA).
- Compared HRT parameters in univariate and multivariate models, adjusting for OCT NFL thickness or HFA MD.
Main Results:
- After adjusting for RGC loss (MD or NFL thickness), significant differences in HRT parameters were found between OAG and both NAION/AAION.
- OAG eyes exhibited larger, deeper cups and smaller rims compared to NAION/AAION eyes with similar damage.
- NFL thickness was greater at the same MD for AAION and NAION compared to OAG.
Conclusions:
- Nonarteritic anterior ischemic optic neuropathy and arteritic anterior ischemic optic neuropathy result in RGC loss with distinct optic disc topography compared to OAG at equivalent levels of damage.
- Confocal laser ophthalmoscopy can help differentiate between these optic neuropathies based on topographic features, even after accounting for RGC loss.
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