[Computer-controlled analysis of the optic papilla with the Optic Nerve Head Analyzer: normal values and various age...

The Rodenstock Optic Nerve Head Analyzer was used to study the disk parameters of 194 eyes of 122 healthy subjects. No age-related changes in the neuroretinal rim area or in the cup/disk ratio could be detected. Furthermore, no significant differences in the mean values of disk parameters were found when right eyes were compared with left eyes or when eyes of male and female subjects were compared. It was thus possible to base calculations of normal values for disk parameters on the entire sample of 194 eyes, irrespective of age and sex. It was also possible to determine the range of variation of these parameters. Statistical analysis of the data produced the following results: the smallest mean neuroretinal rim area is in the temporal disk quadrant; the largest is in the nasal disk quadrant. The mean neuroretinal rim area of the upper quadrant is almost as large as that of the lower quadrant. Consequently, the temporal quadrant has the largest cup/disk ratio, while the nasal quadrant has the smallest. The cup/disk ratios of the upper and lower quadrants are almost identical. The range of variation of all disk parameters was found to be considerable, i.e., the neuroretinal rim area of the whole disk, as well as that of each disk quadrant may be very small, not only in glaucomatous but even in normal eyes. Accordingly, the cup/disk ratio may be large even in normal eyes. Due to the broad range of interindividual variation of disk parameters, a single examination with the Optic Nerve Head Analyzer is not sufficient to distinguish normal from glaucomatous disks. Follow-up examinations are therefore required for early diagnosis of glaucoma, because the finding of a reduction in neuroretinal rim area during follow-up must be interpreted as an important sign of early glaucoma damage.