Correlation between peripapillary atrophy and optic nerve damage in normal-tension glaucoma.
ABSTRACT To investigate the correlation between peripapillary atrophy and visual field defects as well as optic nerve head configurations in patients with normal-tension glaucoma (NTG).
Topographic measurements for peripapillary atrophy and optic nerve head using confocal scanning laser tomography and automated static threshold perimetry were performed on 102 eyes of 51 patients with NTG. Peripapillary atrophy was divided into (1) a central zone (zone Beta) with visible, large choroidal vessels and sclera, and (2) a peripheral zone (zone Alpha) with irregular hyper- and hypopigmentation. The area, angular extent around the disc, and radial extent of each zone were measured.
The area and extent of zone Beta increased significantly with increasing visual field defects expressed in terms of mean deviation, corrected pattern standard deviation, central visual field defects within 5 degrees of fixation, and superior hemifield defects (r = 0.3770-0.5291, P < 0.01). The angular extent of zone Beta represented localized field defects better (r = 0.5217, P < 0.001) than diffuse field defects (r = -0.3770, P < 0.01). Zone Beta significantly correlated with optic nerve head topography. Intraindividual right-left-side differences of corrected pattern standard deviation showed the highest correlation with the side differences of zone Beta area (r = 0.6305, P < 0.001). The location of visual field defects correlated significantly with the location of peripapillary atrophy (chi-square = 9.0484, P = 0.011). Zone Alpha was not significantly correlated with visual field defects or optic nerve head configurations (P > 0.05).
Peripapillary atrophy is significantly associated with functional and structural optic nerve damage in NTG.
Article: Peripapillary changes in glaucoma.[show abstract] [hide abstract]
ABSTRACT: Three observers, unaware of the clinical status of the patients and using projected 35-mm color transparencies, independently graded the degree of peripapillary halo and atrophy in 240 eyes. Analysis of the results revealed that, although patients with glaucoma had more prominent (4+) halos, the average degree of halo was statistically identical for both the glaucomatous and normal eyes. Peripapillary atrophy, on the other hand, was significantly (P less than .01) more extensive in glaucomatous eyes, and 4+ atrophy was seen primarily in eyes with more advanced disease of long duration.American Journal of Ophthalmology 04/1976; 81(3):341-5. · 3.63 Impact Factor
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ABSTRACT: The optic disk vessels of owl monkeys and humans were studied in whole mounts injected with silicone rubber and by serial sections of paraffin-embedded tissue. The capillary bed of the optic nerve head in continuous on one side with the retinal vessels and on the other side with the optic nerve behind the globe. The choriocapillaris is a separate capillary bed, even though it and the disk capillaries are both supplied by branches of the posterior ciliary artery. At the junction between choroid and optic disk is a cuff of vessels that seems equivalent to an anterior extension of the pial vessels. This cuff includes capillaries of the central nervous system, was well as arterial branches of the posterior ciliary artery that pass retrograde from the peripapillary choroid and sclera into the pial plexus. While not contradicting previous descriptions of the vascular anatomy in this region, we emphasized that the microvascular bed of the disk is anatomically an integral part of the retina-optic nerve vascular system and deemphasized its relationship to the choroidal vasculature.American Journal of Ophthalmology 09/1976; 82(2):165-74. · 3.63 Impact Factor
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ABSTRACT: Thirty-one normal human anterior optic nerves were studied in thin serial sections and their vessels stained by standard histologic stains and a new modification of the silver reticulin stain. The retrolaminar cribrosa was profusely supplied by centripetal and longitudinal vessels of pial origin; small branches of the central retinal artery were also seen. Longitudinal continuity of small vessels extended from the retrolaminar nerve to the retinal surface. This system freely anastomosed with three transverse systems; a significant anteriolar input from short posterior ciliary arteries in the sclera to the lamina cribrosa; smaller short posterior ciliary branches and occasional choroidal capillaries to the prelaminar portion; and branches derived from the central retinal artery in and around the disk. Vessels entering the prelaminar region at the level of the choroid were mainly derived from scleral branches of short posterior ciliary vessels entering through the border tissue of Elschnig, rather than from choroidal branches of ciliary arteries. Venous drainage for the anterior optic nerve was primarily through the central retinal vein, although alternate smaller paths to surrounding tissues were also identified.American Journal of Ophthalmology 10/1976; 82(3):405-23. · 3.63 Impact Factor