Cross-sectional anatomic configurations of peripapillary atrophy evaluated with spectral domain-optical coherence tomography.
OBJECTIVE
To evaluate the cross-sectional configurations of peripapillary atrophy (PPA)-alpha and -beta in ophthalmologically normal subjects using spectral domain-optical coherence tomography (SD-OCT).


METHODS
One hundred twenty normal subjects had a complete ophthalmic examination including axial length measurement, standard automated perimetry, fundus imaging with photography, and SD-OCT (3D OCT-1000; Topcon Inc., Tokyo, Japan). PPA-alpha and -beta were identified in color photographs of the optic disc. Cross-sectional B-mode images of the peripapillary retina and sclera, including PPA-alpha and -beta obtained with SD-OCT, were analyzed.


RESULTS
Of 120 normal eyes, 120 (100%) had PPA-alpha and 90 (75%) had PPA-beta. In OCT images of the peripapillary retina, the ganglion cell layer and the inner and outer plexiform layers were observed to end in a tapering fashion at the edge of the optic disc, whereas the retinal nerve fiber layer continued into the optic cup. The external limiting membrane (ELM), inner-outer segments (IS-OS), and retinal pigment epithelium(RPE)/Bruch's membrane complex were significantly more commonly absent before the optic disc edge within the PPA-beta compared with areas outside the PPA-beta (P < 0.0001). Specific findings in the peripapillary area including slope and step configurations of the scleral bed and hump- and wedge-shaped appearances of the RPE-Bruch's membrane complex were identified in 63 (52.5%), 6 (5.0%), 19 (15.8%), and 6 (5.0%) of 120 eyes, respectively. The presence of the step configuration was associated with myopia and longer axial length (P = 0.0014 and 0.0105, respectively).


CONCLUSIONS
The cross-sectional anatomic configurations of the peripapillary atrophy were evaluated by using SD-OCT. The termination of the retinal layers and configurations of the scleral bed in the peripapillary area varied among normal subjects.
Department of Ophthalmology, University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Kelvin Yoon Chiang
KY
Lee
Atsuo
A
Tomidokoro
Rei
R
Sakata
Shinsuke
S
Konno
Chihiro
C
Mayama
Hitomi
H
Saito
Keiko
K
Hayashi
Aiko
A
Iwase
Makoto
M
Araie
D000328:Adult; D000368:Aged; D001284:Atrophy; D002829:Choroid / Q000473:pathology*; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012590:Sclera / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult