Increasing peripapillary atrophy is associated with progressive glaucoma.
OBJECTIVE
This study aimed to determine the incidence and degree of progression of peripapillary atrophy in progressive and nonprogressive glaucoma.


METHODS
A retrospective cohort study.


METHODS
A total of 75 eyes of 75 patients were examined.


METHODS
Qualitative assessment of optic disc, peripapillary atrophy,and visual field change was performed by three experienced, masked, independent observers.


METHODS
Rim-disc area ratio and peripapillary atrophy-disc area ratio were measured at baseline and follow-up with computer-aided planimetry.


RESULTS
Among 75 eyes studied with an average duration of follow-up of 8 years (range, 4-19 years), 33 (44%) showed progressive optic disc damage. Twenty-one (64%) of 33 eyes with progressive disc damage showed peripapillary atrophy progression, and 7 (17%) of 42 eyes without progressive disc damage showed peripapillary atrophy progression; this difference was significant (P < 0.01). In groups with and without peripapillary atrophy, no statistically significant differences were found for mean intraocular pressure, baseline rim-disc area ratio, or baseline peripapillary atrophy-disc area ratio. However, optic disc progression and visual field progression were statistically more frequent in the group with peripapillary atrophy progression (75% and 54%, respectively) than in the group without peripapillary atrophy progression (26% and 11%, respectively) (P < 0.01). There was a statistically significant correlation between measurements of peripapillary atrophy area increase and disc rim loss over time (r = -0.35, P = 0.002).


CONCLUSIONS
Progression of peripapillary atrophy is associated with progressive optic disc damage and progressive visual field loss in glaucoma and may be used as a marker for progressive glaucomatous damage.
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.
H
H
Uchida
S
S
Ugurlu
J
J
Caprioli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009896:Optic Atrophy / Q000150:complications / Q000503:physiopathology*; D009898:Optic Disk / Q000503:physiopathology; D009900:Optic Nerve / Q000503:physiopathology; D012189:Retrospective Studies; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields