[Early detection of glaucoma damage with the Optic Nerve Head Analyzer. A case report]

We present a first case report demonstrating that the Optic Nerve Head Analyzer offers a potential chance to establish glaucomatous damage of the optic disc prior to the appearance of clinically detectable visual field defects. Computerized analysis of the optic disc of a female patient with unilateral irido-corneo-endothelial syndrome revealed a marked loss of neuroretinal rim within sixteen month of follow-up on the affected eye. The neuroretinal rim of her healthy eye was unchanged during this period. Identification and documentation of this ongoing disc damage by means of conventional techniques such as disc photography or nerve fiber layer photography were much more uncertain. Up to now no visual field loss was detectable by computerized perimetry (Octopus G1). This clinical case supports our previous conclusion from theoretical studies: For early diagnosis of glaucoma by means of computerized disc analysis with the Optic Nerve Head Analyzer follow-up measurements of the disc structure are more valid than single examinations.