ARE OPTIC DISC SIZE AND SHAPE RISK FACTORS FOR PROGRESSION OF GLAUCOMA ?

J. B. Jonas, J. K. Hayler, A. Jünemann, W. M. Budde and P. Martus

Department of Ophthalmology, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Germany

Purpose. To evaluate whether the optic disc size and shape are associated with eventual progression of glaucomatous visual field loss in a clinical observational prospective study.

Participants. The study included 357 eyes of 253 Caucasian patients with chronic open-angle glaucoma who were prospectively evaluated. All patients had at least three examinations. The whole study group was differentiated into patients with preperimetric glaucoma (n=148 eyes), and patients with chronic open-angle glaucoma with glaucomatous visual field defects (n=209 eyes). All patients underwent repeated evaluation of color stereo optic disc photographs and white-on-white perimetry. Progression of glaucoma was defined by an increase in the mean visual field defect or an increase in the corrected loss variance value in two consecutive examinations, compared to the values obtained at baseline of the study.

Results.  Out of the 357 eyes, 243 eyes remained stable and 114 eyes showed progression of glaucomatous visual field loss. At baseline of the study, the group of eyes with eventual progression and the group of eyes without progression did not vary significantly (P>0.10) in size of the optic disc and shape of the optic disc as measured by the ratio of horizontal to vertical disc diameter, and by the ratio of minimal to maximal disc diameter. Correspondingly, analysis of variance revealed that the progression of glaucoma was statistically independent of size and shape of the optic disc.

Conclusions. Progression of glaucomatous visual field loss may be independent of size and shape of the optic disc.