Abstract
Purpose: :
To assess the pronounced parapapillary fundus autofluorescence (PAF) in normals, ocular hypertension (OHT) or open angle glaucomas (OAGs=POAG, NTG, PEXG).
Methods: :
Controlled cross–sectional prospective analysis of 349 consecutive eyes (107 controls, 59 OHT, 183 OAGs). The PAF was detected using confocal scanning laser ophthalmoscopy (HRA II, Heidelberg Engineering). Additionally, 15° stereo fundus photographs of the optic nerve head were taken. The stage of glaucomatous optic neuropathy according to Jonas was defined by two experienced ophthalmologists.
Results: :
The PAF–area was smaller in controls (0.07 ± 0.08 mm2) than in OHT (0.16 ± 0.16 mm2; p<0.001). The maximal size of PAF was found in OAGs (0.26 ± 0.45 mm2) in contrast to controls (p<0.01) and OHT (p=0.1). The distance between PAF–area and the optic nerve head was longer in POAG than in OHT (p<0.001) and controls (p<0.001). No PAF was detected in zone beta, but in zone alpha of eyes with OHT or OAG. The amount of PAF was increased with the severity of glaucomatous optic nerve damage (stage 0 – 0.10 mm², stage 1 – 0.20 mm², stages 2 and 3 – 0.24 mm², stage 4 – 0.46 mm²).
Conclusions: :
Manifest glaucomas have more distant and larger PAF–areas in contrast to OHT or controls in descending order. The autofluorescence analysis may visualize "active" retinal pigment epithelium processes in parapapillary atrophic zone alpha in OHT or POAG.
Keywords: optic disc • laser • imaging/image analysis: clinical