Purchase this article with an account.
Sungsoon Hwang, Meenakshisundar Subramanian, Eun Jung Lee, Si Bum Kim, Jong Chul Han, Changwon Kee; Difference of Primary Angle-Closure Glaucoma and Normal-Tension Glaucoma by Optical Coherent Tomography and Confocal Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4004.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Glaucomatous optic neuropathy is caused by elevated intraocular pressure (IOP), and also by IOP-independent factors. In primary angle-closure glaucoma (PACG), glaucomatous change is known to be caused mainly by elevated IOP while factors other than IOP play roles in the pathogenesis of normal-tension glaucoma (NTG). We compared morphologic feature of the optic disc, retinal nerve fiber layer (RNFL), and macular ganglion cell–inner plexiform layer (GC-IPL) between PACG and NTG.
This is a retrospective, comparative, and case-matched study. All patients with PACG and NTG in an early or moderate stage who visited Samsung Medical Center, Seoul, between January 1, 2013 and September 1, 2016 were included in the study. Each of the patients diagnosed with PACG was matched with a patient diagnosed with NTG on the basis of age (within ± 2 year), sex, lens status (phakia or pseudophakia), visual field mean defect (within ± 2 dB), and pattern standard deviation (within ± 3 dB) measured by Humphrey Visual Field Analyser. Optical coherent tomography (OCT) and Confocal Scanning Laser Ophthalmoscopy (cSLO) were used to evaluate optic disc, retinal nerve fiber layer, and macular ganglion cell–inner plexiform layer parameters between the 2 groups.
Seventy three patients with PACG and two hundred fifty five patients with NTG were recruited for the study. Excluding eyes with other ocular comorbidity and advanced stage glaucoma, 40 eyes with PACG were matched to 40 eyes with NTG. The rim area was significantly larger (P<0.05) in the PACG group. Cup-to-disc ratio and total cup volume were significantly smaller (P<0.05) in the PACG group. Average RNFL thickness and average ganglion cell-inner plexiform layer (GC-IPL) thickness from OCT showed no significant difference between the two groups.
The morphologic features of the optic disc in eyes with PACG are different from those with NTG. In the setting of even value of MD of visual field, average RNFL thickness, and average GC-IPL thickness, PACG seems to have less glaucomatous optic nerve head morphology compare to NTG. Elevated IOP and high IOP induced ischemic damage involved in the PACG might have driven those morphologic differences.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only