April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
The Region of Largest Beta-Zone Parapapillary Atrophy Area Predicts the Location of Most Rapid Visual Field Progression
Author Affiliations & Notes
  • C. C. Teng
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • C. G. V. De Moraes
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
    Ophthalmology, NYU Medical Center, New York, New York
  • T. S. Prata
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • C. A. Liebmann
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • C. Tello
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • R. Ritch
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • J. M. Liebmann
    Ophthalmology, NYU Medical Center, New York, New York
  • Footnotes
    Commercial Relationships  C.C. Teng, None; C.G.V. De Moraes, None; T.S. Prata, None; C.A. Liebmann, None; C. Tello, None; R. Ritch, None; J.M. Liebmann, None.
  • Footnotes
    Support  Pierre F. Simon Charitable Trust Research Fund of the New York Glaucoma Research Institute, New York, NY and the Glaucoma Research and Education fund of Lenox Hill Hospital, New York, NY.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 2979. doi:
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      C. C. Teng, C. G. V. De Moraes, T. S. Prata, C. A. Liebmann, C. Tello, R. Ritch, J. M. Liebmann; The Region of Largest Beta-Zone Parapapillary Atrophy Area Predicts the Location of Most Rapid Visual Field Progression. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2979.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : In cross-sectional assessments, the region of largest beta-zone parapapillary atrophy (b-PPA) often corresponds spatially to a region of visual field (VF) damage. We investigated whether the most rapid VF progression occurs in this region.

Methods: : Treated glaucoma patients with >= 9 SITA-Standard 24-2 VFs in either eye from 1999-2008 were identified. Eyes with optic disc photographs, HRT imaging, at least 5 VFs following the HRT, <6 D myopia, b-PPA, and VF progression were studied. b-PPA was defined as a region of chorioretinal atrophy with visible sclera and choroidal vessels adjacent to the optic disc. Using stereophotographs, the disc region (superior vs inferior) with largest amount of b-PPA was identified. Baseline ocular parameters and patient demographics were recorded. VF progression was defined using pointwise linear regression as the presence of a test point with a slope of sensitivity over time >1.0 dB loss/year (P< 0.01). For edge points, a stricter slope criterion of >2.0 dB loss/year (P< 0.01) was used. If both hemifields progressed, we chose the hemifield with fastest rate of progression.

Results: : We enrolled 94 eyes (94 patients; mean age, 71.7±12.9 yrs) with b-PPA and VF progression. Mean values were: baseline IOP, 18.3±4.8 mmHg; CCT, 537±41 um; VF mean deviation, -4.8±3.8 db; disc area, 1.95±0.46 mm2; b-PPA area, 0.86±0.65 mm2; b-PPA area/disc area ratio, 0.45±0.36; rim area, 1.06±0.43 mm2 and rim area/disc area ratio, 0.56±0.23. The mean rate of VF progression was 0.93±0.69 dB/yr. 60 patients (64%) had more b-PPA in the inferior disc region and 34 (36%) in the superior disc region. 63 patients (67%) had fastest VF progression in the superior hemifield and 31 (33%) in the inferior hemifield. The location of most rapid VF progression was consistent with the location of largest b-PPA in 63 (67%) patients (p = 0.012; Fisher’s Exact test, Cohen’s Kappa = 0.27; 95% CI [0.07 - 0.47]; p =0.008).

Conclusions: : In treated glaucoma eyes with b-PPA, the location of most rapid VF progression is likely to occur in the location of largest amount of b-PPA.

Keywords: optic nerve • clinical research methodology • clinical (human) or epidemiologic studies: risk factor assessment 
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