title: An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage.
abstract: From annual examinations of 813 ocular hypertensive eyes, the authors compared optic disc and nerve fiber layer photographs in 2 age-matched subgroups: 37 eyes that converted to abnormal visual field tests at the end of a 5-year period and 37 control eyes that retained normal field tests. Disc change was detected in only 7 of 37 (19%) converters to field loss and in 1 of 37 (3%) controls. Progressive nerve fiber layer atrophy was observed in 18 of 37 (49%) converters and in 3 of 37 (8%) controls. Serial nerve fiber layer examination was more sensitive than color disc evaluation in the detection of progressive glaucoma damage at this early stage of glaucoma. The evaluation of cup-to-disc ratio or of the nerve fiber layer appearance in the initial photograph taken 5 years before field loss were equally predictive of future field damage. The position of nerve fiber layer defects was highly correlated with the location of subsequent visual field loss.
authors.affiliation: Dana Center for Preventive Ophthalmology, Johns Hopkins Hospital, Baltimore, MD 21205.
authors.forename: H A
authors.initials: HA
authors.lastname: Quigley
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: R J
authors.initials: RJ
authors.lastname: Derick
authors.forename: D
authors.initials: D
authors.lastname: Gilbert
authors.forename: A
authors.initials: A
authors.lastname: Sommer
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005901:Glaucoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology; D009798:Ocular Hypertension / Q000175:diagnosis; D009898:Optic Disk / Q000473:pathology*; D010781:Photography / Q000379:methods; D011237:Predictive Value of Tests; D011897:Random Allocation; D014794:Visual Fields