Correlation between peripapillary atrophy and optic nerve damage in normal-tension glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Optic Nerve Head Imaging

Background:

• Normal-tension glaucoma (NTG) is a progressive optic neuropathy characterized by visual field defects and characteristic optic nerve head damage.
• Peripapillary atrophy (PPA) is a common finding in glaucoma, but its specific relationship with functional and structural damage in NTG requires further elucidation.

Purpose of the Study:

• To investigate the correlation between peripapillary atrophy (PPA) and visual field defects.
• To assess the relationship between PPA and optic nerve head (ONH) configurations in patients with normal-tension glaucoma (NTG).

Main Methods:

• Confocal scanning laser tomography and automated static threshold perimetry were used to measure PPA and ONH topography in 102 eyes of 51 NTG patients.
• PPA was categorized into central (zone Beta) and peripheral (zone Alpha) areas, with measurements of area, angular extent, and radial extent.
• Visual field defects were assessed using standard perimetric indices.

Main Results:

• The area and extent of zone Beta significantly correlated with increasing visual field defects, including mean deviation and corrected pattern standard deviation (P < 0.01).
• Zone Beta's angular extent better represented localized field defects, while its area correlated strongly with ONH topography and side differences in visual field loss (P < 0.001).
• Zone Alpha showed no significant correlation with visual field defects or ONH configurations (P > 0.05).

Conclusions:

• Peripapillary atrophy, specifically zone Beta, is significantly associated with both functional visual field loss and structural optic nerve damage in NTG.
• These findings suggest that PPA is a valuable indicator for assessing the severity and progression of optic nerve damage in normal-tension glaucoma.