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Non-quantitative morphologic features in normal and glaucomatous optic discs.

J B Jonas1, N X Nguyen, G O Naumann

  • 1Department of Ophthalmology, University of Erlangen-Nurnberg, FRG.

Acta Ophthalmologica
|August 1, 1989
PubMed
Summary
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Non-quantitative signs in optic disc topography help diagnose glaucoma. Key indicators include changes in nerve fiber layers and parapapillary atrophy, aiding early detection of glaucomatous optic nerve damage.

Area of Science:

  • Ophthalmology
  • Optometry

Background:

  • Glaucoma is a leading cause of irreversible blindness.
  • Optic disc topography changes are characteristic of glaucoma.
  • Early diagnosis is crucial for managing glaucoma and preventing vision loss.

Purpose of the Study:

  • To evaluate the diagnostic value of non-quantitative signs of optic disc topography in chronic primary open-angle glaucoma.
  • To identify specific topographic features that effectively differentiate between normal and glaucomatous optic discs.

Main Methods:

  • Color stereo photographs of optic discs from 308 glaucoma patients and 236 normal subjects were analyzed.
  • Non-quantitative signs, including nerve fiber layer changes, parapapillary atrophy, neuroretinal rim characteristics, and cupping/pallor ratios, were assessed.

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  • Statistical analysis focused on predictive values for differentiating between normal and glaucomatous eyes.

    • Main Results:

    • 'Changes in juxtapapillary retinal nerve fiber layers' showed the highest predictive value (86.7%).
    • Other significant parameters included abnormal size/location of parapapillary chorio-retinal atrophy (79.8%/68.6%), smallest neuroretinal rim sector (78.5%), and cupping larger than pallor area (68.2%).
    • Optic disc hemorrhages, bared cilioretinal arteries, and bared circumlinear vessels exhibited high specificity but low sensitivity.

    Conclusions:

    • Non-quantitative assessment of optic disc topography provides valuable insights for diagnosing glaucomatous optic nerve damage.
    • These easily evaluated signs are useful for ad hoc diagnosis, independent of advanced imaging techniques.
    • The identified parameters can aid clinicians in differentiating glaucoma from normal optic discs.