Prognostic significance of optic disk cupping in ocular hypertensive patients

The stereoscopic photographs of 102 patients with increased intraocular pressure (IOP) and normal visual fields were graded for cup:disk ratio. All patients were followed up for a five-year period, during which time 27 patients developed glaucomatous visual field loss and 75 patients did not. The patients who subsequently developed glaucomatous visual field loss had significantly larger cup:disk ratios than did the patients who did not develop glaucomatous visual field loss. Patients with a mean IOP greater than or equal to 28 mm Hg and a vertical contour cup:disk ratio greater than or equal to 0.6 had a 100% incidence of the development of glaucomatous visual field loss as compared to a 2% incidence in those with a mean IOP less than 28 mm Hg and a vertical cup:disk ratio less than 0.6. Disk:cup asymmetry and progressive increase in the area of the disk occupied by the cup was more common in the group that developed glaucomatous visual field loss.