Elsevier

Ophthalmology

Volume 99, Issue 1, January 1992, Pages 19-28
Ophthalmology

An Evaluation of Optic Disc and Nerve Fiber Layer Examinations in Monitoring Progression of Early Glaucoma Damage

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From annual examinations of 813 ocular hypertensive eyes, the authors compared optic disc and nerve fiber layer photographs in 2 age-matched subgroups: 37 eyes that converted to abnormal visual field tests at the end of a 5-year period and 37 control eyes that retained normal field tests. Disc change was detected in only 7 of 37 (19%) converters to field loss and in 1 of 37 (3%) controls. Progressive nerve fiber layer atrophy was observed in 18 of 37 (49%) converters and in 3 of 37 (8%) controls. Serial nerve fiber layer examination was more sensitive than color disc evaluation in the detection of progressive glaucoma damage at this early stage of glaucoma. The evaluation of cup-to-disc ratio or of the nerve fiber layer appearance in the initial photograph taken 5 years before field loss were equally predictive of future field damage. The position of nerve fiber layer defects was highly correlated with the location of subsequent visual field loss.

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Supported in part by Public Health Service Research Grants EY 02120, EY 01765, EY 03605, RR 04060, and by funds provided by National Glaucoma Research, a program of American Health Assistance Foundation, Rockville, Maryland, and by a Senior Investigator Award from Research to Prevent Blindness, Inc, New York, New York.