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Jost B. Jonas, Antonio Bergua, Paul Schmitz–Valckenberg, Konstantinos I. Papastathopoulos, Wido M. Budde; Ranking of Optic Disc Variables for Detection of Glaucomatous Optic Nerve Damage. Invest. Ophthalmol. Vis. Sci. 2000;41(7):1764-1773.
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purpose. To describe optic disc variables assessed by evaluation of clinical
optic disc photographs and to compare sensitivity and specificity of
these optic disc parameters in identifying patients with ocular
hypertension who have nerve fiber layer defects and normal visual
fields and patients with visual field defects.
methods. The study included 500 normal subjects, 132 patients with ocular
hypertension with retinal nerve fiber layer defects and normal visual
fields (preperimetric glaucoma), and 840 patients with glaucomatous
visual field defects. Color stereo optic disc photographs were
results. Highest diagnostic power for the separation between the normal group
and the preperimetric glaucoma group had the vertical cup-to-disc
diameter ratio corrected for its dependence on the optic disc size,
total neuroretinal rim area, rim-to-disc area ratio corrected for disc
size, and cup-to-disc area ratio corrected for disc size. Diagnostic
power was lower for rim area in the temporal inferior and temporal
superior disc sector, cup area corrected for disc size, and horizontal
cup-to-disc diameter ratio corrected for disc size. Less useful for the
differentiation between the normal subjects and the preperimetric
glaucoma group were size of zones alpha and beta of parapapillary
chorioretinal atrophy, and ratios of neuroretinal rim width and rim
area comparing various optic disc sectors with each other.
conclusions. In subjects with ocular hypertension with retinal nerve fiber layer
defects and normal conventional achromatic visual fields, the vertical
cup-to-disc diameter ratio corrected for optic disc size, total
neuroretinal rim area, rim-to-disc area ratio, and cup-to-disc area
ratio corrected for disc size are the most valuable optic disc
variables for early detection of glaucomatous optic nerve damage.
Correction for optic disc size is necessary for optic disc variables
directly or indirectly derived from the optic cup. Parapapillary
atrophy is less important in the early detection of
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