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Optic disc morphology in juvenile primary open-angle glaucoma
1Department of Ophthalmology, Friedrich-Alexander University, Erlangen, Germany.
Insights
Younger primary open-angle glaucoma (POAG) patients exhibit distinct optic disc morphology, including deeper cupping and higher intraocular pressure, compared to older POAG patients.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Optic Nerve Imaging
Background:
- Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
- Understanding variations in POAG presentation based on age is crucial for effective management.
- Optic disc morphology is a key indicator of glaucoma progression.
Purpose of the Study:
- To investigate differences in optic disc morphology between younger (<40 years) and older (≥40 years) patients with POAG.
- To identify specific morphometric characteristics associated with early-onset POAG.
Main Methods:
- Morphometric analysis of optic disc stereo photographs from 419 POAG patients.
- Comparison of two matched subgroups: 37 patients <40 years and 382 patients ≥40 years.
- Neuroretinal rim area was used as a matching parameter between subgroups.
Main Results:
- Younger POAG patients demonstrated significantly deeper and steeper optic disc cupping.
- Concentric neuroretinal rim emaciation and smaller parapapillary atrophy areas were observed in younger patients.
- Higher maximal and minimal intraocular pressure (IOP) readings were significantly associated with the younger subgroup (P < 0.001).
Conclusions:
- Younger POAG patients (<40 years) exhibit unique optic disc morphology compared to older patients.
- The observed morphology in younger POAG patients suggests chronic high-pressure open-angle glaucoma with diffuse optic nerve damage.
- Distinct morphologic features and elevated IOP in young POAG patients warrant tailored clinical attention.
Background:
The aim of the study was to evaluate whether, in primary open-angle glaucoma (POAG), patients younger than 40 years differ in optic disc morphology from patients older than 40 years.
Methods:
Out of a total group of 419 patients with POAG, we formed and compared two subgroups, one consisting of 37 patients with an age of less than 40 years, the other composed of 382 patients with an age equal to or more than 40 years. Both subgroups were matched for neuroretinal rim area. We examined the optic disc morphometrically using stereo disc photographs.
Results:
The younger subgroup, as compared to the older subgroup, showed deeper and steeper optic disc cupping, concentric emaciation of the neuroretinal rim, a significantly smaller area of parapapillary atrophy, and significantly higher maximal and minimal intraocular pressure measurements (P < 0.001). The size and shape of the optic disc and the diameter of the retinal vessels at the optic disc border did not vary significantly.
Conclusions:
In POAG, patients younger than 40 years differ in optic disc morphology from patients older than 40 years. The younger patients with POAG have high minimal and maximal intraocular pressure readings and an optic disc morphology with deep and steep cupping, concentric loss of neuroretinal rim, and an almost unremarkable parapapillary atrophy. POAG in patients under 40 represents chronic high-pressure open-angle glaucoma with mainly diffuse optic nerve damage.