Glaucomatous optic nerve atrophy: the circumlinear vessel revisited.
Baring of a circumlinear vessel, or gap sign, is a sign of glaucomatous optic neuropathy that can be rapidly assessed during direct ophthalmoscopy. We previously found a significant association between the presence of this sign and the diagnosis and status of visual field defects. In the current study we followed this same group of patients for a mean of 78 months. The rate of agreement between two independent observers for the presence or absence of a circumlinear vessel was 79%, and the intraobserver rate was 71%. The corresponding rates for the presence of a gap sign were 84% and 90%. The presence of baring was significantly associated with development of a visual field defect in the glaucoma suspect group (p = 0.0105). The development of a gap sign in photographs taken approximately 6 years later was significantly associated with clinical progression of the appearance of the disc or the visual field defect (p = 0.0142). We conclude that patients with baring of a circumlinear vessel should be closely monitored for the development or progression of the glaucomatous process.
Department of ophthalmology, Sir Mortimer B. Davis Jewish General Hospital, Montreal.
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Kasner
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Balazsi
D002908:Chronic Disease; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D015588:Observer Variation; D009798:Ocular Hypertension / Q000175:diagnosis*; D009896:Optic Atrophy / Q000175:diagnosis*; D009898:Optic Disk / Q000098:blood supply*; D010781:Photography; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000473:pathology*; D014794:Visual Fields