Analysis of neuroretinal rim distribution and vascular pattern in eyes with presumed large physiological cupping: a comparative study

Analysis of neuroretinal rim distribution and vascular pattern in eyes with presumed large physiological cupping: a comparative study

Author Lopes, Flavio S. S. Autor UNIFESP Google Scholar
Dorairaj, Syril Google Scholar
Junqueira, Daniela L. M. Google Scholar
Furlanetto, Rafael Lacerda Autor UNIFESP Google Scholar
Biteli, Luis Gustavo Autor UNIFESP Google Scholar
Prata, Tiago Santos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hosp Med Olhos
Mayo Clin
Abstract Background: To investigate possible differences in neuroretinal rim distribution, vascular pattern, and peripapillary region appearance between eyes with presumed large physiological optic disc cupping (pLPC) and eyes with minimal optic disc excavation.Methods: We prospectively enrolled consecutive subjects with pLPC and individuals with minimal excavation (optic disc excavation within normal limits; control group). All eyes had normal visual fields and untreated intraocular pressure (IOP) <21 mmHg. Eyes with pLPC required vertical cup-to-disc ratio (VCDR) >= 0.6 and >= 30 months of follow-up with no evidence of glaucomatous neuropathy. for controls, VCDR was limited to <= 0.5. We compared ocular signs and characteristics related to the neuroretinal rim distribution, vascular pattern, peripapillary region appearance and disc size between groups. Whenever both eyes were eligible, one was randomly selected for analysis.Results: A total of 74 patients (mean age, 45.6 +/- 14.9 years) with pLPC and 45 controls (mean age, 44.8 +/- 11.6 years) were enrolled (p = 0.76). Median disc size and VCDR was significantly larger in eyes with pLPC compared to controls (p < 0.01). the proportion of eyes with violation of the ISNT rule, laminar dot sign, nasal shifting of the central vessels, nasal excavation and baring of circumlinear vessel was significantly greater in the eyes with pLPC compared to controls (p < 0.01). There were no significant differences regarding the proportions of eyes with peripapillary atrophy between groups (p < 0.09). Finally, disc size was significantly associated with VCDR (r(2) = 0.47, p < 0.01), with an increase of 0.21 in VCDR for each 1 mm(2) in disc area.Conclusion: Compared to normal controls, eyes with pLPC may present a higher proportion of optic nerve head findings frequently observed in glaucomatous eyes. This seems to be explained in part by the larger discs found in these eyes. We believe care should be taken while classifying them as glaucomatous or not based solely on these characteristics.
Keywords Glaucoma suspect
Intraocular pressure
Optic disc cup
Disc size
Language English
Date 2014-05-27
Published in Bmc Ophthalmology. London: Biomed Central Ltd, v. 14, 5 p., 2014.
ISSN 1471-2415 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent 5
Origin http://dx.doi.org/10.1186/1471-2415-14-72
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000336856400001
URI http://repositorio.unifesp.br/handle/11600/37783

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