Topographic Relationship with a Retinal Nerve Fiber Layer Defect Differs between  β -Zone and  γ -Zone Parapapillary Atrophy

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Abstract

Introduction

γ-Zone parapapillary atrophy (PPA), an associated feature in myopic tilted optic disc, is considered to be relevant with glaucomatous optic nerve damage in myopic eyes. This study determines the topographic relationship of γ-zone PPA with a retinal nerve fiber layer defect.

Purpose

To determine the topographic relationship of γ-zone PPA with a RNFL defect and to compare it with that of β-zone PPA.

Design

Cross-sectional, observational study. Participants. Eighty-nine eyes from 89 patients with primary open-angle glaucoma who had β-zone PPA ( n = 49) or γ-zone PPA ( n = 40) and a single localized RNFL defect.

Methods

PPA was classified according to the presence or absence of Bruch's membrane on the PPA bed in spectral-domain optical coherence tomography. The angular location of the point of maximum radial extent of PPA (PMRE) and the RNFL defect was measured with the fovea-disc axis set at 0° in color and red-free fundus photographs. Main Outcome Measures. Angular distance between the RNFL defect and the PMRE.

Results

There was no significant intergroup difference in the extent of the RNFL defect ( P=0.920). The angular distance between the RNFL defect and the PMRE was significantly greater in γ-zone than β-zone PPA (26.49 ± 17.27° vs. 60.31 ± 17.12°, P < 0.001). The angular location of the PMRE was significantly correlated with the location of the RNFL defect in the β-zone group ( r = 0.822, P < 0.001) but not in the γ-zone group. The RNFL defect was mostly located near the edge of γ-zone PPA in the γ-zone group (10.56 ± 9.47°).

Conclusions

An RNFL defect was observed near the edge of PPA in eyes with γ-zone PPA, in contrast to it being close to the PMRE in eyes with β-zone PPA.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: not found

Natural history of open-angle glaucoma.

Anders Heijl, Boel Bengtsson, Leslie Hyman … (2009)

This article, based on the Early Manifest Glaucoma Trial (EMGT), provides prospective natural history data on progression of glaucomatous field defects in 3 of the most common glaucoma types. Cohort of EMGT patients randomized to the untreated control group and followed up to the time of progression, when treatment could be initiated. We evaluated 118 control patients: 46 with high-tension glaucoma (HTG), 57 with normal-tension glaucoma (NTG), and 15 with pseudoexfoliation glaucoma (PEXG). Visual fields were tested every 3 months with the Humphrey 30-2 Full Threshold test program. Linear regression analyses of the perimetric mean deviation (MD) values were performed, and the rate of progression was defined as the regression coefficient in decibels per year. Percentages of progressed eyes and time to progression were determined using EMGT event-based predetermined progression criteria derived from Glaucoma Change Probability Maps. The median and interquartile rates of visual function loss were -0.40 (1.05) dB/year overall and -0.46 (1.61) in HTG, -0.22 (0.65) in NTG, and -1.13 (6.13) in PEXG. Thus, interpatient variability was large. Mean rates were considerably higher than medians: -1.08 dB/year overall, -1.31 in HTG, -0.36 in NTG, and -3.13 in PEXG. Differences in median visual function progression rates among groups were statistically significant (NTG vs. HTG, P = 0.003; PEXG vs. non-PEXG, P<0.001). Progression was considerably and significantly faster in older than in younger patients (P = 0.002). By 6 years, 68% of patients had progressed overall, 74% of those with HTG, 56% of those with NTG, and 93% of those with PEXG (P = 0.012). Median time to progression also differed considerably among groups: 19.5 months in PEXG, 44.8 months in HTG, and particularly 61.1 months in NTG (P<0.0001). In this 6-year follow-up study, the median untreated rate of progression corresponded to advancing from normal visual function to blindness in approximately 70 years, whereas on the basis of the mean rate, visual function would show the same deterioration in approximately 25 years. Large differences existed among patients and different glaucoma types, with PEXG progressing considerably faster than HTG, and NTG progressing at the lowest rate.

0 comments Cited 116 times – based on 0 reviews      Review now

Record: found
Abstract: not found
Article: not found

Blood supply of the optic nerve head and its role in optic atrophy, glaucoma, and oedema of the optic disc.

S Hayreh (1969)

0 comments Cited 101 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Parapapillary chorioretinal atrophy in normal and glaucoma eyes. I. Morphometric data.

Vy X Nguyen, J. Jonas, G Naumann … (1989)

Glaucomatous optic nerve damage is associated with alterations of the intra- and parapapillary optic disc area. We measured and compared the parapapillary region in 582 eyes of 321 patients suffering from chronic primary open-angle glaucoma and in 390 eyes of 231 normal subjects. Only one randomly assessed eye per patient and subject was taken for statistical analysis. Highly mopic eyes with a myopic refractive error of more than -8.00 diopters had been excluded. The parapapillary chorioretinal atrophy was divided into a peripheral zone "Alpha" with irregular hyper- and hypopigmentation, and a more central zone "Beta" characterized by whitish colour, visible large choroidal vessels and visible sclera. In the normal eyes both zones were significantly (P less than 0.001) largest and most common in the temporal horizontal sector, followed by the inferior temporal sector, the superior temporal sector and finally the nasal sector. In the glaucoma group both zones were significantly larger (P less than 0.0001; Mann-Whitney test) and more frequent than in the normal eyes (0.40 +/- 0.32 mm2 versus 0.65 +/- 0.49 mm2 for zone Alpha, 0.13 +/- 0.42 mm2 versus 0.79 +/- 1.17 mm2 for zone Beta). The differences were significant also for the earliest glaucoma stage of this study. They were most marked for the nasal parapapillary sector. Significant differences (P less than 0.001) between the normal group and the earliest glaucoma stage were: zone Alpha larger than 0.20 mm2 or broader than 0.20 mm in the temporal horizontal sector, total area of zone Alpha larger than 0.30 mm2, occurrence of zone Alpha in the nasal sector, and occurrence of zone Beta anywhere.

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Author and article information

Contributors

Tae-Woo Kim:

ORCID: https://orcid.org/0000-0002-5180-0978

Journal

Journal ID (nlm-ta): J Ophthalmol

Journal ID (iso-abbrev): J Ophthalmol

Journal ID (publisher-id): JOPH

Title: Journal of Ophthalmology

Publisher: Hindawi

ISSN (Print): 2090-004X

ISSN (Electronic): 2090-0058

Publication date Collection: 2020

Publication date (Electronic): 21 August 2020

Volume: 2020

Electronic Location Identifier: 6279689

Affiliations

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

²Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea

Author notes

Academic Editor: Dirk Sandner

Author information

Tae-Woo Kim https://orcid.org/0000-0002-5180-0978

Article

DOI: 10.1155/2020/6279689

PMC ID: 7463418

SO-VID: ba8af2d9-5618-4582-b042-daa6e0285ad7

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 20 April 2020

Date revision received : 9 June 2020

Date accepted : 25 June 2020

Funding

Funded by: Seoul National University

Topographic Relationship with a Retinal Nerve Fiber Layer Defect Differs between β-Zone and γ-Zone Parapapillary Atrophy

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