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Optic disc and early glaucomatous visual field loss.

S M Hyung¹, D M Kim, D H Youn

¹Department of Ophthalmology, College of Medicine, Seoul National University, Korea.

Korean Journal of Ophthalmology : KJO

|December 1, 1990

Summary

Early glaucoma detection is crucial. A specific optic disc measurement, the ratio of the thinnest neuroretinal rim width, effectively predicts early visual field loss in glaucoma patients.

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Area of Science:

Ophthalmology
Medical Imaging
Glaucoma Research

Background:

Optic disc assessment is vital for early glaucoma detection, preceding visual field loss.
Glaucoma diagnosis relies on identifying characteristic changes in the optic disc structure.

Purpose of the Study:

To evaluate glaucomatous optic discs and identify features associated with early visual field loss.
To determine specific morphologic parameters of the optic disc that correlate with incipient visual field defects.

Main Methods:

Studied 43 eyes from 28 patients with a cup/disc ratio > 0.4 and no visual field defect.
Utilized stereoscopic examination of optic disc photographs (Canon fundus camera, Polaroid film) to assess parameters like C/D ratio, cupping, vessel characteristics, and neuroretinal rim width.
Correlated optic disc findings with automated static perimetry (Humphrey program C30-2 with STATPAC).

Main Results:

Stereophotography yielded higher cup/disc (C/D) ratios than direct ophthalmoscopy.
The "Ratio of the thinnest neuroretinal rim (NRR) width in the vertical sectors to the NRR width of the temporal sector less than or equal to 85%" showed the highest probability for differentiating early glaucomatous discs from normal ones.
Stereo disc photography with Polaroid film is a practical method for documenting changes.

Conclusions:

The ratio of the thinnest neuroretinal rim width to the temporal sector width is a strong predictive parameter for detecting early visual field loss in glaucoma.
Stereoscopic disc photography, even with Polaroid film, offers a valuable and accessible tool for monitoring glaucoma progression and identifying at-risk individuals.

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