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Martha Kim, Tae-Woo Kim, Robert N. Weinreb, Se Joon Woo, Kyu Hyung Park, Kyu Hyung Park, Jeong-Min Hwang; Patterns of Parapapillary Atrophy in Children. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1581.
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To describe morphologic changes in the optic nerve head (ONH) and parapapillary tissue associated with development and/or enlargement of parapapillary atrophy (PPA) in children.
This study included 266 eyes of 133 subjects who were assessed by serial disc photography at intervals of 1 year or more. All disc photographs were reviewed by two experienced ophthalmologists, and eyes with development and/or enlargement of PPA were selected. The morphologic changes in the ONH and parapapillary tissue associated with the development and/or enlargement of PPA were analyzed.
Progressive PPA was detected in 72 eyes of 43 subjects. Mean subject age at the time of initial fundus examination was 7.8 ± 2.5 years (range, 1-16 years) and mean follow-up period was 37.0 ± 18.2 months (range, 12-77 months). The morphologic changes were classified into four categories. The most common type was inward growth of PPA with apparent shrinkage of the ONH (51 eyes, 70.8%) followed by, in order of frequency, bidirectional growth of PPA, (14 eyes, 19.4%), apparent shifting of the ONH (5 eyes, 6.9%), and outward growth of PPA (2 eyes, 2.8%).
We demonstrate that the morphologic changes associated with the development and/or enlargement of PPA vary considerably among children. Inward growth of PPA with accompanying shrinkage of the ONH, a previously unreported phenomenon, was the most prevalent pattern observed.
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