P 362
Degree of glaucomatous damage and family history of glaucoma
J. K. Hayler
Background: A positive family history is one of the main risk factors for glaucoma. Purpose of the present study was to evaluate whether patients with a known family history of glaucoma have a more advanced stage of the disease than patients with an unremarkable family history.
Patients and Methods: The study included 654 consecutive patients (328 w, 326 m; age 63.3 ± 12.9 years) with primary open-angle glaucoma. All patients included in the study were asked whether family members had glaucoma. For all patients, 15 degree color stereo optic disc photographs were morphometrically evaluated.
Results: The patients with a positive family history of glaucoma(n=148/654= 22.6%) and the patients with an unremarkable family history for glaucoma(n=506/654=77.4%) did not vary significantly (Mann-Whitney test) in the area of the neuroretinal rim (0.96±0.53 mm2 (median, 0.92 mm2) versus 0.87± 0.51 mm2 (median, 0.88 mm2); P=0.09), optic disc (2.68±0.66 mm2 (median, 2.61 mm2) versus (2.70±0.75 mm2 (median, 2.57 mm2); P=0.81), beta zone of parapapillary atrophy (0.80±1.54 mm2 (median, 0.32 mm2) versus 0.93±1.47 mm2 (median, 0.43 mm2); P=0.22), frequency of optic disc hemorrhages (10/148=6.8% versus 21/506=4.2%; P=0.19; Chi-Square-test), and mean visual field loss (9.67±7.16 dB (median, 7.1 dB) versus 9.87±7.08 dB (median, 7.60 dB); P=0.85).
Discussion: In contrast to reports in which a positive family history was associated with the prevalence of glaucoma, the present study suggests that a family history of glaucoma is statistically independent of the degree of glaucomatous optic neuropathy. One may infer that a positive family history of glaucoma may not be a major risk factor for progression of glaucoma. It supports a previous study by Quigley et al. who did not find an association of family history of glaucoma with the development of glaucomatous field loss in ocular hypertensive subjects (Arch Ophthalmol 1994; 112: 644-649).
Dept. Ophthalmology Univ. Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen