Parapapillary atrophy in the chronic open-angle glaucomas.

Abstract

A study was carried out to evaluate whether parapapillary atrophy varies among different chronic open-angle glaucomas. The study included 625 Caucasian patients with primary open-angle glaucoma (POAG), 123 patients with secondary open-angle glaucoma (pseudoexfoliative glaucoma n=86; pigmentary glaucoma n=37), and 481 normal subjects. POAG was differentiated into highly myopic POAG (n=32), juvenile POAG (n=33), focal normal-pressure glaucoma (n=46), "sclerotic POAG" with marked fundus tesselation (n=89), and "ordinary POAG" comprising the remaining POAG eyes (n=425). Color stereo optic disc photographs were morphometrically evaluated. The beta zone of parapapillary atrophy was significantly larger in sclerotic POAG (1.00+/-1.37 mm(2)) than in pseudoexfoliative glaucoma (0.65+/-0.93 mm(2)), pigmentary glaucoma (0.42+/-0.58 mm(2)), ordinary POAG (0.66+/-1.06 mm(2)), and focal normal-pressure glaucoma (0.34+/-0.36 mm(2)). In ordinary POAG, the beta zone was significantly larger than in juvenile POAG (0.33+/-0.72 mm(2)). Compared with all glaucoma groups, the beta zone was significantly the smallest in the normal eyes (0. 18+/-0.57 mm(2)). The alpha zone of parapapillary atrophy was significantly larger in the glaucoma groups than in the normal control group, with no significant difference between the glaucoma groups. The myopic crescent (4.11+/-3.42 mm(2)) present in the highly myopic eyes was significantly larger than the beta zone in any other group. The beta zone of parapapillary atrophy varies by a factor of more than 3 between the various types of chronic primary and secondary open-angle glaucomas. This may be important diagnostically and pathogenetically.