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I. An Evaluation as a Predictive Factor for the Development of Glaucomatous Damage

Gülgün Tezel, MD; Allan E. Kolker, MD; Michael A. Kass, MD; Martin B. Wax, MD; Mae Gordon, PhD; Kimberly D. Siegmund, PhD

Arch Ophthalmol. 1997;115(12):1503-1508.

Abstract
Objective
To determine whether parapapillary chorioretinal atrophy is a risk factor for the development of glaucomatous optic disc or visual field damage.

Methods
The initial morphometric parameters of the optic disc and parapapillary atrophy were retrospectively investigated in 350 eyes of 175 patients with ocular hypertension. The prognostic value of parapapillary atrophy at the baseline examination and its relationship with known risk factors for the development of glaucomatous damage were analyzed by multivariate analysis.

Results
Visual field loss, optic disc damage, or both were detected in 98 eyes of 53 patients during the follow-up period of at least 10 years. By univariate analysis, the presence of parapapillary atrophy, as well as higher parapapillary atrophy area—disc area, zone β area—disc area, and parapapillary atrophy length—disc circumference ratios, at the baseline examination was associated with the conversion to glaucoma. In addition, higher intraocular pressure, larger vertical cupdisc ratio, and smaller neural rim area—disc area ratio at the baseline examination were associated with subsequent glaucomatous optic nerve damage. In a multivariate regression model adjusted for other factors, intraocular pressure (relative risk, 1.19), neural rim area—disc area ratio (relative risk, 0.72), and zone β area—disc area ratio (relative risk, 1.32) were found to be associated with the development of optic disc damage, visual field damage, or both.

Conclusion
The presence and the size of parapapillary atrophy are related to the development of subsequent optic disc or visual field damage in patients with ocular hypertension.

Author Affiliations
From the Department of Ophthalmology and Visual Sciences (Drs Tezel, Kolker, Kass, and Wax) and the Division of Biostatistics (Drs Gordon and Siegmund), Washington University School of Medicine, St Louis, Mo. None of the authors has a proprietary interest in any of the materials used in this study.

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