ACQUIRED PIT OF THE OPTIC-NERVE - A RISK FACTOR FOR PROGRESSION OF GLAUCOMA

PURPOSE: To examine acquired pit of the optic nerve as a risk factor f or progression of glaucoma. METHODS: In a retrospective longitudinal s tudy, 25 open-angle glaucoma patients with acquired pit of the optic n erve were compared with a group of 24 open-angle glaucoma patients wit hout acquired pit of the optic nerve. The patients were matched for ag e, mean intraocular pressure, baseline ratio of neuroretinal rim area to disk area, visual field damage, and duration of follow-up. Serial o ptic disk photographs and visual fields of both groups were evaluated by three independent observers for glaucomatous progression, RESULTS: Of 46 acquired pits of the optic nerve in 37 eyes of 25 patients, 36 p its were located inferiorly (76%) and 11 superiorly (24%; P < .001), P rogression of optic disk damage occurred in 16 patients (64%) in the g roup with acquired pit and in three patients (12.5%) in the group with out acquired pit (P < .001), Progression of visual field loss occurred in 14 patients (56%) in the group with acquired pit and in six (25%) in the group without pit (P = .04), Bilateral acquired pit of the opti c nerve was present in 12 patients (48%). Disk hemorrhages were observ ed more frequently in the group with acquired pit (10 eyes, 40%) compa red with the group without pit (two eyes, 8%; P=.02). CONCLUSION: Amon g patients with glaucoma, patients with acquired pit of the optic nerv e represent a subgroup who are at increased risk for progressive optic disk damage and visual field loss. (C) 1998 by Elsevier Science Inc. All rights reserved.