Rates of neuroretinal rim and peripapillary atrophy area change: a comparative study of glaucoma patients and normal controls.
OBJECTIVE
To compare the rates of global and sectoral neuroretinal rim area (NRA) and peripapillary atrophy area (PPAA) change in open-angle glaucoma patients and normal control subjects and to determine the relationship between rates of NRA and PPAA change.


METHODS
Prospective, longitudinal cohort study of cases and controls.


METHODS
Ninety-four patients with open-angle glaucoma and 54 control subjects.


METHODS
Patients and controls were imaged with confocal scanning laser tomography every 6 months. The NRA and PPAA in 1 eye were analyzed to determine the rate of change globally and in 12 30 degrees sectors by regression analysis. Rates of global NRA and PPAA change were correlated. Sectors were ranked from 1 to 12 each according to the magnitude of NRA and PPAA change and were compared between patients and controls using rank-order correlation. Spatial concordance between rates of NRA and PPAA change was calculated as sector rank distance between correspondingly ranked sectors.


METHODS
Rates of global and sectoral NRA and PPAA change.


RESULTS
The mean (+/-standard deviation) follow-up was 8.6+/-2.9 years for patients and 7.1+/-3.6 years for controls. Globally, NRA declined more rapidly in patients compared with controls, expressed either in absolute units (medians, -5.33x10(-3) mm(2)/year and -1.25x10(-3) mm(2)/year, respectively; P = 0.006) or percentage of baseline NRA (medians, -0.42%/year and -0.07%/year, respectively; P = 0.001). The global rate of PPAA change was not significantly higher in patients compared with controls (12.66x10(-3) mm(2)/year and 9.43x10(-3) mm(2)/year, respectively; P = 0.173). Rates of global and sectoral NRA and PPAA change were correlated poorly in either group. There was a high correlation between ranked sectors of NRA change in patients and controls (P</=0.001), indicating similar patterns of NRA decline in patients and controls; however, this was not the case for rates of PPAA change.


CONCLUSIONS
These findings indicate an age-related regional susceptibility of the optic disc that may be accelerated in glaucoma. The poor relationship between rates of NRA and PPAA change suggests their temporal dynamics are uncoupled.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
See
Jovina L S
JL
Department of Ophthalmology and Visual Sciences, Dalhousie University, 1278 Tower Road, Halifax, Nova Scotia, Canada.
Nicolela
Marcelo T
MT
Chauhan
Balwantray C
BC
D016022:Case-Control Studies; D018450:Disease Progression; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006068:Gonioscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007429:Intraocular Pressure / Q000502:physiology; D007834:Lasers; D008137:Longitudinal Studies; D008875:Middle Aged; D009896:Optic Atrophy / Q000503:physiopathology*; D009898:Optic Disk / Q000473:pathology*; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D014054:Tomography; D014792:Visual Acuity / Q000502:physiology