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M.F. Haque, B.A. Hughes, C. Kim; Clinical Assessment versus Optical Coherence Tomography Assessment of the Optic Nerve in Glaucomatous Patients With and Without Peripapillary Atrophy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3318.
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Purpose: To compare the clinical assessment of the optic nerve cup/disc ratio performed by a glaucoma specialist with quantitative assessment of the cup/disc ratio using optical coherence tomography (OCT) in glaucoma patients with and without peripapillary atrophy. Methods: A retrospective chart review was performed. Patients were examined by the same glaucoma specialist followed by OCT of the optic nerve in one or both eyes. Clinical cup/disc ratio by 90 diopter slit lamp examination and average cup/disc ratio measured by OCT were recorded along with patients' age, sex, race, diagnosis, intraocular pressure (IOP), duration of treatment and presence or absence of peripapillary atrophy. Paired and unpaired t–tests and chi square tests were used for statistical analysis. Results: 194 eyes of 101 patients were reviewed. There were no differences between patients with and without peripapillary atrophy with respect to age, sex, race, diagnosis, intraocular pressure (IOP), or duration of treatment. There was no statistically significant difference in the clinical versus OCT assessment of the optic nerve cup/disc ratio in patients with or without peripapillary atrophy (p=.371). The cup/disc ratio was significantly larger in patients with peripapillary atrophy compared to patients without peripapillary atrophy in both clinical assessment (p=.009) and in OCT analysis (p=.0003). Conclusion: There is no difference in cup/disc assessment with clinical evaluation versus OCT analysis in the setting of peripapillary atrophy. Glaucoma patients with peripapillary atrophy had significantly larger cup/disc ratios than patients without peripapillary atrophy.
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