Optic nerve head appearance in juvenile-onset chronic high-pressure glaucoma and normal-pressure glaucoma

Objective: To evaluate the appearance of the optic nerve head in chronic hi gh-pressure glaucoma and normal-pressure glaucoma. Design: Clinic-based cross-sectional study. Participants: The study included 52 eyes with normal-pressure glaucoma and 28 eyes with juvenile-onset primary open-angle glaucoma that sewed as model s for chronic high-pressure glaucoma. Methods: Color stereo optic disc photographs and wide-angle retinal nerve f iber layer photographs were morphometrically examined. Main Outcome Measures: Localized retinal nerve fiber layer defects; parapap illary chorioretinal atrophy; disc hemorrhages; optic cup shape; retinal ar teriole narrowing. Results: Both study groups did not vary significantly in count of localized retinal nerve fiber layer defects, size of parapapillary atrophy, optic cu p depth, steepness of disc cupping, rim/disc area ratio, diameter of retina l arterioles, and frequency and degree of focal retinal arteriole narrowing . In normal-pressure glaucoma versus juvenile open-angle glaucoma, localize d retinal nerve fiber layer defects were significantly broader, disc hemorr hages were found significantly more often and were larger, and neuroretinal rim notches were present more frequently and were deeper. Conclusions: Chronic high-pressure glaucoma and normal-pressure glaucoma sh ow morphologic similarities in the appearance of the optic nerve head. The tower frequencies of detected disc hemorrhages and rim notches in high-pres sure glaucoma may be due to a smaller size of hemorrhages and localized ret inal nerve fiber layer defects in high-pressure glaucoma. Both glaucoma typ es have morphologic features in common, suggesting that they may possibly b elong to a spectrum of the same pathologic process. (C) 2000 by the America n Academy of Ophthalmology.