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PURPOSE: To compare optic disc topography in eyes in three intraocular pressure (IOP) groups of <15 mmHg, 15-20 mmHg, and ≥21 mmHg using spectral domain optical coherence tomography (SD-OCT) and confocal scanning laser ophthalmoscopy, adjusting for the degree of damage, as measured by retinal nerve fiber layer (RNFL) thickness and average visual field loss. METHODS: A total of 184 eyes of 112 patients with primary open-angle glaucoma were recruited into groups based on baseline untreated intraocular pressure (IOP) of <15 mmHg (normal-tension glaucoma [NTG], very low), 15-20 mmHg (NTG, medium), or ≥21 mmHg (high-tension glaucoma [HTG]). Patients underwent scanning laser ophthalmoscopy, SD-OCT, and Humphrey visual field testing. Univariate and multivariate models were created, accounting for degree of retinal ganglion cell (RGC) loss by either OCT RNFL thickness or visual field mean deviation (MD). RESULTS: Univariate and multivariate analyses demonstrated no morphological differences in HRT or OCT parameters among IOP groups that met Bonferroni-corrected statistical significance when using either MD or OCT RNFL as the damage criterion (p < 0.0063). The mean cup depth was shallower for the IOP <15 mmHg group than the IOP ≥21 mmHg group (p < 0.05) for both MD (p < 0.011) and OCT RNFL (p < 0.014). CONCLUSION: Normal-tension and high-tension glaucoma are not distinguishable by optic nerve head topography with HRT and OCT when the degree of damage by Humphrey visual field testing is taken into account.
Department of Ophthalmology, The University of Auckland, Auckland, New Zealand.
Full article9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)