ACQUIRED PITS OF THE OPTIC-NERVE IN GLAUCOMA - PREVALENCE AND ASSOCIATED VISUAL-FIELD LOSS

Purpose: This study was performed to determine the prevalence of acqui red pits of the optic nerve (APON) in glaucoma and the characteristics of associated visual field loss. Subjects and Methods: Stereoscopic o ptic disc photos from 235 patients with a low-tension variety of prima ry open-angle glaucoma (LTG) and 251 primary open-angle glaucoma patie nts with intraocular pressures higher than 21 mmHg (HTG) were examined for the presence of typical APON as defined by a standard photograph (Fig 1). Associated visual field loss was evaluated with automated per imetry and patterns of field loss were identified. Results: Out of a t otal of 486 patients, 63 APON were found in 51 eyes of 44 glaucoma pat ients. APONs were more prevalent in women. Acquired pits were more fre quently (p<0.001) located inferiorly (70%) than superiorly (30%). Ther e was a significantly higher prevalence (p<0.001) of APON in LTG patie nts (12.7%) than in HTG patients (5.6%). Dense visual field defects wi thin five degrees of fixation occurred in 96% of patients with APON. C onclusion: Acquired pits of the optic nerve are more often located at the inferior optic disc than at the superior disc and are nearly alway s associated with visual field loss close to fixation. In a glaucoma r eferral center setting, APON are more prevalent in lower pressure glau coma than in higher pressure glaucoma.