OPTIC DISC MORPHOLOGY IN JUVENILE PRIMARY OPEN-ANGLE GLAUCOMA

Background: The aim of the study was to evaluate whether, in primary o pen-angle glaucoma (POAG), patients younger than 40 years differ in op tic disc morphology from patients older than 40 years. Methods: Out of a total group of 419 patients with POAG, we formed and compared two s ubgroups, one consisting of 37 patients with an age of less than 40 ye ars, the other composed of 382 patients with an age equal to or more t han 40 years. Both subgroups were matched for neuroretinal rim area. W e examined the optic disc morphometrically using stereo disc photograp hs. Results: The younger subgroup, as compared to the older subgroup, showed deeper and steeper optic disc cupping, concentric emaciation of the neuroretinal rim, a significantly smaller area of parapapillary a trophy, and significantly higher maximal and minimal intraocular press ure measurements (P<0.001). The size and shape of the optic disc and t he diameter of the retinal vessels at the optic disc border did not va ry significantly. Conclusions: In POAG, patients younger than 40 years differ in optic disc morphology from patients older than 40 years. Th e younger patients with POAG have high minimal and maximal intraocular pressure readings and an optic disc morphology with deep and steep cu pping, concentric loss of neuroretinal rim, and an almost unremarkable parapapillary atrophy. POAG in patients under 40 represents chronic h igh-pressure open-angle glaucoma with mainly diffuse optic nerve damag e.