Ying Zi Pan, Ze Qin Ren, Mei Li, Rong Hua Qiao
Department of Ophthalmology, Peking University First Hospital, Beijing, China

Aim: To evaluate the relationship between peripapillary atrophy, cup-disc ratio, and visual field defect in Chinese patients with primary open angle glaucoma.
Methods: The study included 45 eyes of 45 patients with primary open angle glaucoma with high intraocular pressure and 40 eyes of 40 patients with normal tension glaucoma. Forty patients had unilateral visual field defects. Stereoscopic colour optic disc photographs were morphometrically evaluated.
Results: Both the α-zone area and the β-zone area weakly correlated with glaucomatous visual field defects, while cup-disc ratio showed a relatively strong correlation with visual field defects. Only cup-disc ratio and age were found to be risk factors for the occurrence of visual field defects by logistic regression analysis. Among the 40 patients with unilateral visual field defects, the cup area, cup-disc ratio, and α-zone area of the eyes with visual field defects were significantly greater than in the eyes without visual field defects (cup area, p < 0.001; cup-disc ratio, p < 0.0001; α-zone area, p = 0.0045). There was no significant difference in β-zone area between the 2 eyes (p = 0.426). The frequency of occurrence of peripapillary atrophy was also similar between the 2 eyes.
Conclusions: The relationship between peripapillary atrophy and the severity of visual field defects might not be as strong as that between cup-disc ratio and visual field defects. The occurrence and the areas of peripapillary atrophy may not be as clinically useful as the classical optic disc parameters of cup-disc ratio, either for diagnosing or for predicting the status of visual field defects in patients with glaucoma.

Key words: Atrophy, Glaucoma, open-angle, Visual fields

Asian J Ophthalmol. 2008;10:114-117.