The papilla and visual field in glaucoma. Relation between planimetrically determined papilla and visual field changes

Abstract

From 126 patients with ocular hypertension and/or primary open-angle glaucoma, those (n = 18) who had an untreated intraocular pressure of at least 25 mm Hg or a cup/disk ratio of at least 0.8 were selected for this study. The course of the disease was followed by means of photos of the disk and visual field examinations performed with an automated perimeter. The area of the neuroretinal rim was measured planimetrically. The mean period of observation was 3.7 years, in the course of which the size of neuroretinal rim became decreased in 10 patients, merely fluctuated in 6 patients, and increased in 2 patients. No definite correlation between the course of the visual fields and that of changes in the neuroretinal rim could be demonstrated at either the first or the last examination. Nonetheless, when the visual field changes were juxtaposed to those in the neuroretinal rim, a tendency to a decrease in rim area and an increase in visual field losses was noted. However, numerous exemplary cases showed that one cannot necessarily predict visual field losses from the size of the rim and vice versa. Comparison of estimated rim areas with those determined planimetrically obviously verifies that planimetry provides more accurate results.