The parapapillary region of normal and glaucoma eyes. I. Planimetric values of 312 glaucoma and 125 normal eyes

Abstract

Magnification-corrected planimetry of the parapapillary region was performed according to Littmann's method in 312 unselected eyes with chronic primary open-angle glaucoma and in 125 normal eyes of an age- and refraction-matched control group using optic disk photographs. The glaucoma group was divided into five pathomorphologic subgroups. High myopics (less than -8.00 D) and "ocular hypertensives" had been excluded. The coefficient of variation ranged intraindividually from 0.0 to 0.17 and interindividually from 0.0 to 0.16. Two different morphologic variants were defined and examined: 1) Zone "Alpha" with incipient to advanced parapapillary chorio-pigmentepithelio-retinal atrophy - characterized by irregular hypo- and hyperpigmentation - was statistically proven in the control group (0.60 +/- 0.44 mm2; p less than 0.05; Wilcoxon-Mann-Whitney test) to be smaller than in the glaucoma group (0.81 +/- 0.70 mm2). It increased significantly (p = 0.0000) with advancing glaucoma stage. In the glaucoma and normal group it was broadest in the temporal horizontal sector (p less than 0.001; Wilcoxon test), followed by the temporal lower (p less than 0.001), temporal upper (p less than 0.001) and nasal sectors (p less than 0.001). There was no significant difference in prevalence between the two groups. 2) Zone "Beta" with subtotal to total parapapillary chorio-pigment-epithelio-retinal atrophy was also smaller in the normal eyes (0.18 +/- 0.52 mm2, prevalence: 20.0%; p = 0.0000) than in the glaucomatous ones (0.85 +/- 1.42 mm2, prevalence 66.7%) and was also, in both groups, broadest in the temporal horizontal sector, followed by the temporal lower, temporal upper and nasal sectors. In the control group it was smaller than zone "Alpha" (p less than 0.00001), while in the glaucoma group there was no difference. 3) The difference between normal eyes and earliest glaucoma stage I was for zone "Beta" (p = 0.0000); the difference between the normal eyes and those of glaucoma stage II was significant for both zones (p = 0.0000 and p less than 0.05, respectively). In both groups and in all glaucoma stages both zones were larger in the lower half of the optic disk than in the upper half. 4) "Conus pigmentosus" and the peripapillary scleral rim in normal and glaucomatous eyes showed no significant difference as regards their area and frequency. The parapapillary chorio-pigmentepithelio-retinal alterations are precursors of, or are equivalent to the so-called "halo glaucomatosus".(ABSTRACT TRUNCATED AT 400 WORDS)