Parapapillary lLpofuscin Accumulation in Normals, Ocular Hypertensives, and Primary Open-angle Glaucomas
Viestenz A., Langenbucher A., Mardin C. Y.
Department of Ophthalmology, University Erlangen-Nuernberg, Erlangen
Purpose: To assess the pronounced autofluorescence of parapapillary atrophic zones in ocular hypertension (OHT) or primary open angle glaucoma (POAG) compared with normals.
Method: 79 eyes (15 normals, 28 OHT, 36 POAG) were examined in a cross-sectional nonrandomized prospective controlled study. Eyes with retinal or RPE-pathologies were excluded. A confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph) after excitation with argon green laser (488 nm) was used to detect parapapillary autofluorescence in a bandwidth above 500 nm. Size and extension of parapapillary autofluorescent area and the distance to the optic disc were measured.
Results: Only a few lipofuscin granules were observed in the parapapillary region in normal eyes (0.036 ± 0.048 mm2). The parapapillary autofluorescent area was higher in OHT (0.110 ± 0.136 mm2) than in normals (p=0.013). The maximum of lipofuscin was found in POAG (0.436 ± 0.986 mm2) in contrast to normals (p=0.02) and OHT (p=0.058). The width and length (extension) of parapapillary autofluorescent areas was larger in POAG than in OHT, and in OHT larger than in normal eyes (p<0.03). The distance between lipofuscin and the optic nerve was longer in POAG than in OHT and normals (p<0.002). This distance did not differ between OHT and normals (p=0.8).
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