Abstract
Purpose::
The purpose of this study was to investigate morphologic predictive factors for the development of glaucoma in patients with ocular hypertension (OHT).
Methods::
Two hundred eighteen eyes of 109 patients with OHT (normal visual field, healthy optic disc appearance, IOP > 21 mmHg) and an observation period of more than 5 years were included in the study. All patients received an annual, detailed, standardized glaucoma examination. 21 eyes of 17 patients had marked neuroretinal rim loss and development of glaucomatous optic disc atrophy during follow up, identified by masked comparative evaluation of stereographic optic disc slides by two experienced observers independently from each other. 13 eyes of 10 patients from this subgroup developed reproducible visual field defects. Standard HRT-parameter (global and sector analysis) from baseline examination were compared between stable and progressive patients.
Results::
Significant differences between both groups were found for most of the investigated parameters. In the progressive OHT group rim area (1.41±0.33 vs. 1.70±0.36; p<0.001) and rim volume (0.31±0.13 vs. 0.44±0.17; p<0.01) were significant lower. Results were similar for global data as well as for sector analysis without preference for a particular sector.
Conclusions::
Patients with OHT and conversion to early glaucoma during follow up had already at baseline a lower neuroretinal rim area and rim volume as detected by scanning laser tomography, if compared with the non-progressive group. This supports recent studies showing that low neuroretinal rim area and volume in healthy discs may be a risk factor for the development of glaucoma.
Keywords: optic disc • imaging/image analysis: clinical