[Morphologic papillar signs of high pressure glaucoma]

Area of Science:

• Ophthalmology
• Glaucoma Research
• Optic Nerve Morphology

Context:

• Open-angle glaucoma is a leading cause of irreversible blindness.
• Understanding optic disc morphology in different glaucoma subtypes is crucial for diagnosis and management.
• High-pressure glaucoma presents unique challenges in differentiating it from primary open-angle glaucoma.

Purpose:

• To compare the optic disc morphology in eyes with secondary open-angle glaucoma and juvenile open-angle glaucoma (Group I) versus primary open-angle glaucoma (Group II).
• To investigate the relationship between intraocular pressure, optic disc size, parapapillary atrophy, and optic disc shape in glaucoma patients.

Summary:

• Eyes with high-pressure glaucoma (Group I) exhibited significantly higher maximal intraocular pressure and smaller optic discs and parapapillary atrophy compared to Group II.
• A trend towards deeper cupping and fewer optic disc hemorrhages was observed in Group I.
• Optic disc shape did not significantly differ between the groups, suggesting it is not a distinguishing feature.

Impact:

• Minor parapapillary atrophy may indicate high-pressure glaucoma, but its limited enlargement suggests partial independence from intraocular pressure elevation.
• Barotrauma in high-pressure glaucoma may lead to diffuse optic nerve damage.
• Optic disc shape is not a reliable parameter for identifying high-pressure glaucoma, emphasizing the need for other diagnostic markers.