Peripapillary Atrophy in Normal and Primary Open-Angle Glaucoma

This study was undertaken in order to determine the value of measuring peripapillary atrophy for the diagnosis and follow-up of patients with glaucoma, and to evaluate how closely peripapillary atrophy is related to structural and functional optic nerve damage in glaucoma. Magnification-corrected morphometry of photographs using a computer graphic program and automated static threshold perimetry were performed in 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects. The groups were not significantly different in age, refractive error or disc area. Zones α and β were significantly larger, total peripapillary atrophy was significantly more extensive, and zone β occurred more often in the glaucoma group than in the normal group. The frequency of zone β increased with advancing glaucoma stage. The areas of zones α and β and total peripapillary atrophy increased significantly with decreasing rim/disc area ratio, rim area, and mean deviation, and with increasing vertical and horizontal cup-to-disc ratios and cup area. Correlation coefficients were generally higher for zone β than for zone α.