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Abstract #9784 Published in IGR 5-3
Relationship of optic disc topography and visual function in patients with large cup-to-disc ratios
Mansberger SL; Zangwill LM; Sample PA; Choi D; Weinreb RNAmerican Journal of Ophthalmology 2003; 136: 888-894
PURPOSE: To determine whether topographical differences exist between large cup-to-disc ratio (C/D) eyes with standard achromatic automated perimetry (SAP) abnormalities and those with only short-wavelength automated perimetry (SWAP) abnormalities. DESIGN: Cross-sectional study. METHODS: The setting was a referral university-based clinical practice. The authors selected one eye of 72 patients with a vertical C/D of at least 0.8 by ophthalmoscopy. Patients performed SWAP, SAP, and confocal scanning laser ophthalmoscopy. They compared optic disc topography in eyes with and without visual field abnormalities and controlled for the influence of disc area. RESULTS: Disc area was a confounder of many topographical measures. After controlling for disc area, eyes with abnormal SAP had differences in rim volume, cup shape, rim area, retinal nerve fiber layer thickness, and retinal nerve fiber layer cross-sectional area when compared with eyes with normal SAP (p < 0.05). Rim volume and rim area were different in the SWAP comparison (p < 0.05). CONCLUSIONS: Investigators should control for disc area when evaluating topographic measures by confocal scanning laser ophthalmoscopy. In eyes with a large C/D, optic disc topography is more glaucomatous in eyes with SAP abnormalities than in those with only SWAP abnormalities. Eyes with large C/D and only SWAP abnormalities may have fewer glaucomatous optic disc changes than such eyes with SAP abnormalities. This indicates that SWAP is likely to correspond to abnormalities in optic disc topography at an earlier stage of glaucomatous optic neuropathy than SAP. Therefore, clinicians should consider SWAP testing in glaucoma suspects to detect glaucomatous visual field loss at an earlier stage of structural loss.
Dr. S.L. Mansberger, Devers Eye Institute/Discoveries in Sight, Portland, OR 97210, USA. smansberger@discoveriesinsight.org
Classification:
6.9.1 Laser scanning (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)