Abstract
Abstract: :
Purpose: Progression of parapapillary atrophic zone ß is correlated with progression of morphologic glaucomatous damage. Histologic and spectroscopic results revealed an accumulation of lipofuscin in lysosomes of retinal pigmentepithelium in the parapapillary atrophic zone α. We investigated area and intensity of parapapillary autofluorescence in patients with ocular hypertension and controls. Methods: 112 eyes from 65 patients with ocular hypertension and 47 eyes from 25 controls were investigated in a controlled prospective cross–sectional trial. All patients and controls received complete ophthalmologic examination and detailed standardized glaucoma examination including blue on yellow–VEP. Additional patients and controls were investigated with confocal scanning laser ophthalmoscop (HRA, Heidelberg Engineering) to detect lipofuscin in the parapapillary atrophic zone. Eyes with retinal diseases or pathologic changes of retinal pigmentepithelium were excluded. The area of parapapillary autofluorescence was measured with HRA standard software. For measuring the maximal intensity of parapapillary autofluorescence 20° mean images (TIF–Format, 8 bit/pixel) were exported and analyzed with software tool ImageJ 1.32j (NIH, USA). Results: The area of parapapillary autofluorescence was significant larger in patients with ocular hypertension than in the control group (0,15 ± 0,16 mm² vs. 0,07 ± 0,08 mm²; p<0,01). In patients with ocular hypertension the area of parapapillary autofluorescence is week positive correlated with age (r=0,264; p<0,01). If the intensity of maximal parapapillary autofluorescence was > 220, a significant prolongation of latentcy in blue on yellow–VEP was found in patients with ocular hypertension (124 ± 14 ms vs. 140 ± 18 ms; p<0,01). There was no significant difference in age between patient and control group. Conclusions: We detected an increased extension of parapapillary autofluorescence in patients with ocular hypertension. Patients with a high intensity of parapapillary autofluorescence had also an increased latency in blue on yellow–VEP. Since extension of parapapillary atrophic zone ß and blue on yellow–VEP latency is correlated with the stage of glaucomatous damage, measuring of parapapillary autofluorescence could probably become a new diagnostic tool in glaucoma. Further studies are necessary to detect parameters with predictive power for progression of glaucomatous damage. Supported by Deutsche Forschungsgemeinschaft SFB 539 "Glaukome und Pseudoexfoliationssyndrom"
Keywords: optic disc • retinal pigment epithelium