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II. An Evaluation of Progressive Changes

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

Arch Ophthalmol. 1997;115(12):1509-1514.

Abstract
Objective
To determine whether parapapillary chorioretinal atrophy in patients with ocular hypertension remained stationary or progressed along with glaucomatous optic nerve damage.

Methods
The morphometric parameters and progression of parapapillary atrophy were retrospectively investigated, using serial photographs, in 350 eyes of 175 patients with ocular hypertension. The association of parapapillary atrophy progression with subsequent glaucomatous conversion and with other baseline patientand eye-specific characteristics was analyzed.

Results
Progression in the area and extension of parapapillary atrophy before noticeable optic disc or visual field changes was observed in 48 (49.0%) of 98 eyes that converted to glaucoma, while parapapillary atrophy progression was noted in 25 (9.9%) of 252 ocular hypertensive eyes that did not develop glaucomatous damage (P<.001). The predictive sensitivity and specificity of this observation were 49% and 90%, respectively. In a logistic multiple regression model, the progression of parapapillary atrophy was associated with a family history of glaucoma (odds ratio, 2.7) and the initial size of zone β (odds ratio, 1.64, for an increase of 0.10 of the zone β area—disc area ratio).

Conclusion
The progression of parapapillary chorioretinal atrophy may be an early glaucomatous finding in some patients with ocular hypertension.

Author Affiliations
From the Department of Ophthalmology and Visual Sciences (Drs Tezel, Kolker, Wax, and Kass) 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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