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Increasing peripapillary atrophy is associated with progressive glaucoma

H Uchida1, S Ugurlu, J Caprioli

  • 1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.

Ophthalmology
|August 26, 1998
PubMed
Summary

Progression of peripapillary atrophy in glaucoma is linked to worsening optic disc damage and visual field loss. This finding suggests peripapillary atrophy can serve as an indicator of glaucoma progression.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Optic Nerve Imaging

Background:

  • Glaucoma is a leading cause of irreversible blindness.
  • Peripapillary atrophy (PPA) is a common finding in glaucoma.
  • The relationship between PPA progression and glaucoma progression is not fully understood.

Purpose of the Study:

  • To determine the incidence and progression of peripapillary atrophy (PPA) in glaucoma patients.
  • To assess the association between PPA progression and optic disc damage and visual field loss.

Main Methods:

  • Retrospective cohort study of 75 eyes over an average of 8 years.
  • Qualitative assessment of optic disc, PPA, and visual field changes by masked observers.
  • Quantitative measurement of rim-disc and PPA-disc area ratios using computer-aided planimetry.

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Main Results:

  • 44% of eyes showed progressive optic disc damage.
  • PPA progression occurred in 64% of eyes with disc damage and 17% without.
  • PPA progression was significantly associated with optic disc (75% vs. 26%) and visual field progression (54% vs. 11%).
  • A significant correlation was found between PPA area increase and disc rim loss (r = -0.35, P = 0.002).

Conclusions:

  • Progression of peripapillary atrophy is significantly associated with progressive optic disc damage and visual field loss in glaucoma.
  • Peripapillary atrophy progression may serve as a valuable marker for identifying progressive glaucomatous damage.