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Impressum
Morphologic risk factors for progressive glaucomatous optic nerve head changes
1,2Jonas J. B., 1Budde W. M., 1Hayler J., 2Jünemann A., 3,4Martus P.
1Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Germany, 2Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68167 Mannheim, Germany; 3Department for Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nurnberg, Erlangen, Germany; 4Department for Medical Informatics, Biometry and Epidemiology, FU Berlin, Klinikum Benjamin Franklin, Berlin, Germany Corresponding author: Dr. J. Jonas, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; Phone: **49-621-383-2652; Fax: **49-621-383- 3803; e-mail: Jost.Jonas@augen.ma.uni-heidelberg.de
Purpose: To evaluate which morphologic features of the optic disc
are risk factors for progressive optic nerve head changes in glaucoma.
Patients and Methods: The prospective clinical observational study
included 300 eyes of 186 Caucasian patients with chronic open-angle glaucoma.
The whole study group was differentiated into a progressive group with
loss of neuroretinal rim and into a stable group without morphologic changes
of the optic nerve head during the follow-up period. Eyes with optic disc
hemorrhages were excluded from the study. All patients underwent repeated
qualitative and morphometric evaluation of color stereo optic disc photographs.
Mean follow-up time was 27.4 ± 17.0 months.
Results: At baseline of the study, neuroretinal rim area was significantly
(P=0.001) smaller and beta zone of parapapillary atrophy was significantly
(P=0.002) larger in the progressive study group compared with non-progressive
study group. Both study groups did not vary significantly (P>0.10)
in size and shape of the optic disc, optic cup depth, alpha zone of parapapillary
atrophy, and diameter of the retinal arteries and veins.
Conclusions: Important morphologic risk factors for progression
of the glaucomatous appearance of the optic nerve head are size of neuroretinal
rim and area of beta zone of parapapillary atrophy. Progression of glaucomatous
optic nerve head changes is independent of size and shape of the optic
disc, size of alpha zone of parapapillary atrophy, retinal vessel diameter,
and optic cup depth.