Neuroretinal rim width ratios in morphological glaucoma diagnosis
J B Jonas, W M Budde, P Lang, J B Jonas, W M Budde, P Lang
Abstract
Aims: To evaluate the inferior to temporal neuroretinal rim width ratio and superior to temporal rim width ratio as measures of rim shape for diagnosis of glaucoma.
Methods: Colour stereo optic disc photographs of 527 normal subjects, 100 ocular hypertensive individuals with normal visual fields, and 202 open angle glaucoma patients with a mean perimetric defect of less than 10 dB were morphometrically evaluated. Eyes with an optic cup area of < 0.2 mm2 were excluded.
Results: In the normal subjects, inferior to temporal rim width ratio (1.67 (SD 0.53)) was significantly (p < 0.0001) higher than superior to temporal rim width ratio (1.56 (0.49)). Both ratios were significantly (p < 0.0001) higher the more vertically the optic disc was configured. In the normal eyes, both ratios were statistically independent of disc size, rim area, refractive error, age, and sex. With the differences being more marked for the inferior to temporal ratio than for the superior to temporal ratio, both rim width ratios were significantly (p < 0.005) lower in the ocular hypertensive group than in the normal group. Despite the high significance of the differences, diagnostic power of the inferior ratio and the superior ratio was 59% and 58%, respectively, indicating a marked overlap between the groups.
Conclusions: Abnormally low inferior to temporal and superior to temporal rim width ratios can indicate glaucomatous optic nerve damage in some ocular hypertensive eyes. Being independent of optic disc size and ocular magnification, the rim width ratios may be taken as one among other variables for the ophthalmoscopic optic disc evaluation, taking into account, however, a pronounced overlap between normal eyes and ocular hypertensive eyes.
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References
- Br J Ophthalmol. 1975 Dec;59(12):721-4
- Graefes Arch Clin Exp Ophthalmol. 1992;230(6):552-60
- Arch Ophthalmol. 1992 Feb;110(2):206-10
- Arch Ophthalmol. 1992 Feb;110(2):211-3
- Ophthalmology. 1992 Jan;99(1):36-40
- Graefes Arch Clin Exp Ophthalmol. 1991;229(1):57-61
- Am J Ophthalmol. 1991 Apr 15;111(4):485-90
- Graefes Arch Clin Exp Ophthalmol. 1988;226(6):587-90
- Invest Ophthalmol Vis Sci. 1988 Jul;29(7):1151-8
- Ophthalmology. 1987 Nov;94(11):1484-7
- Am J Ophthalmol. 1985 Jan 15;99(1):1-4
- Arch Ophthalmol. 1973 Apr;89(4):278-86
- Am J Ophthalmol. 1973 Mar;75(3):442-54
- Am J Ophthalmol. 1970 Nov;70(5):681-5
- Arch Ophthalmol. 1984 Jul;102(7):1011-4
- Klin Monbl Augenheilkd. 1982 Apr;180(4):286-9
- Arch Ophthalmol. 1978 Dec;96(12):2209-11
- Arch Ophthalmol. 1980 Mar;98(3):490-5
- Am J Ophthalmol. 1995 May;119(5):627-36
- Br J Ophthalmol. 1994 Oct;78(10):775-80
- Arch Ophthalmol. 1994 Aug;112(8):1068-76
- Br J Ophthalmol. 1994 Feb;78(2):99-102
- Am J Ophthalmol. 1994 Jun 15;117(6):732-40
- Arch Ophthalmol. 1993 Jan;111(1):62-5
- Acta Ophthalmol (Copenh). 1993 Feb;71(1):122-9
- Graefes Arch Clin Exp Ophthalmol. 1993 Apr;231(4):193-8
- Invest Ophthalmol Vis Sci. 1993 Jun;34(7):2260-5
- Am J Ophthalmol. 1996 May;121(5):494-501
- Invest Ophthalmol Vis Sci. 1996 Nov;37(12):2393-401
- Graefes Arch Clin Exp Ophthalmol. 1996 Dec;234(12):750-4
- Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1976 Mar-Apr;81(2):217-23
- Acta Ophthalmol (Copenh). 1976 Dec;54(6):804-18
Source: PubMed