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.
Department of Ophthalmology, Gifu University School of Medicine, Japan.
H
H
Uchida
T
T
Yamamoto
G
G
Tomita
Y
Y
Kitazawa
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