INCREASING PERIPAPILLARY ATROPHY IS ASSOCIATED WITH PROGRESSIVE GLAUCOMA

Objective: This study aimed to determine the incidence and degree of p rogression of peripapillary atrophy in progressive and nonprogressive glaucoma. Study Design: A retrospective cohort study. Participants: A total of 75 eyes of 75 patients were examined. Main Outcome Measures: Qualitative assessment of optic disc, peripapillary atrophy, and visua l field change was performed by three experienced, masked, independent observers. Methods: Rim-disc area ratio and peripapillary atrophy-dis c area ratio were measured at baseline and follow-up with computer-aid ed planimetry. Results: Among 75 eyes studied with an average duration of follow-up of 8 years (range, 4-19 years), 33 (44%) showed progress ive optic disc damage, Twenty-one (64%) of 33 eyes with progressive di sc damage showed peripapillary atrophy progression, and 7 (17%) of 42 eyes without progressive disc damage showed peripapillary atrophy prog ression; this difference was significant (P < 0.01). In groups with an d without peripapillary atrophy, no statistically significant differen ces were found for mean intraocular pressure, baseline rim-disc area r atio, or baseline peripapillary atrophy-disc area ratio. However, opti c disc progression and visual field progression were statistically mor e frequent in the group with peripapillary atrophy progression (75% an d 54%, respectively) than in the group without peripapillary atrophy p rogression (26% and 11%, respectively) (P < 0.01), There was a statist ically significant correlation between measurements of peripapillary a trophy area increase and disc rim loss overtime (r = -0.35, P = 0.002) . Conclusion: Progression of peripapillary atrophy is associated with progressive optic disc damage and progressive visual field loss in gla ucoma and may be used as a marker for progressive glaucomatous damage.