Peripapillary atrophy in primary angle-closure glaucoma: a comparative study with primary open-angle glaucoma.
OBJECTIVE
To investigate the characteristics of peripapillary atrophy in primary angle-closure glaucoma and to compare peripapillary atrophy in primary angle-closure glaucoma with that in primary open-angle glaucoma.


METHODS
Twenty-one eyes (of 21 patients) with chronic primary angle-closure glaucoma that had no evidence of an acute attack or combined-mechanism glaucoma and 31 eyes (31 patients) with primary open-angle glaucoma were enrolled in this study. The cup-to-disk area ratio and the visual field mean deviation were matched in both groups. The prevalence of peripapillary atrophy and peripapillary atrophy-to-disk area ratio of eyes with primary angle-closure glaucoma and eyes with primary open-angle glaucoma were compared. The correlation between the peripapillary atrophy area and the cup-to-disk area ratio or the mean deviation was also evaluated.


RESULTS
Eight (38%) of 21 eyes with primary angle-closure glaucoma and 21 (68%) of 31 eyes with primary open-angle glaucoma had peripapillary atrophy. The peripapillary atrophy-to-disk area ratio averaged 0.16 in primary angle-closure glaucoma and 0.41 in primary open-angle glaucoma. There were statistically significant differences regarding the prevalence of peripapillary atrophy (P = .048) and peripapillary atrophy-to-disk area ratio (P = .005) between the two groups. There was no significant correlation between the peripapillary atrophy area and the cup-to-disk area ratio or the mean deviation in primary angle-closure glaucoma. In contrast, the peripapillary atrophy-to-disk area ratio significantly correlated with the cup-to-disk area ratio (P = .003) and the mean deviation (P = .0001) in primary open-angle glaucoma.


CONCLUSIONS
The peripapillary atrophy in primary angle-closure glaucoma has a different relationship to the structural and functional optic disk changes than that in primary open-angle glaucoma. Different mechanisms seem to be involved in the development of the optic disk damage in the two types of glaucoma.
Uchida
H
H
Department of Ophthalmology, Gifu University School of Medicine, Japan.
Yamamoto
T
T
Tomita
G
G
Kitazawa
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D015862:Choroid Diseases / Q000150:complications / Q000473:pathology; D003430:Cross-Sectional Studies; D015812:Glaucoma, Angle-Closure / Q000150:complications* / Q000473:pathology; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009896:Optic Atrophy / Q000150:complications* / Q000473:pathology; D009898:Optic Disk / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000150:complications / Q000473:pathology; D014054:Tomography / Q000379:methods; D014794:Visual Fields