Morphometric changes in optic discs with morphologic progression of the glaucomatous optic atrophy measured with laser-scanning-tomography

Aim: Aim of this study was to measure morphometric changes in optic discs w ith laser-scanning tomography (HRT, Heidelberg-Retina-Tomograph. Heidelberg ) in eyes with early glaucomatous morphologic progression. Patients and methods: 61 eyes of 36 patients with marked neuroretinal rim l oss or its early morphologic signs (1. optic disc hemorrhages, 2. reduced v isibility of the retinal nerve fiber layer (RNF), 3. appearance of narrowin g of retinal vessels, 4. enlargement of the choroidal, parapapillary atroph y) were compared to 74 normal eyes of 39 probands, 15 degrees stereographs of the optic discs were evaluated for morphologic changes. The morphometric variables of the neuroretinal rim and excavation measured by the HRT were examined in the course of the disease. Results: In the group of normals no significant changes of the neuroretinal rim in the course of 2.0 +/- 1.2 years were found. In the group of glaucom atous eyes (3.0 +/- 1.5 years follow-up) 34 eyes showed marked neuroretinal rim loss, 17 disc hemorrhages, 4 vessel narrowing, 3 an increased chorioid al atrophy, 3 a decreased visibility of the retinal nerve fiber layer. In t hese eyes a significant loss of rim area (p = 0.01) and an increase of exca vation area (p = 0.0001) and volume (p = 0.003) was measured by the HRT. On ly three eyes showed a perimetric loss of sensitivity (0.8-3.4 db) in Octop us static perimetry. Conclusions: Laser-scanning tomography of the optic disc seems to be able t o measure morphometric changes in eyes with morphologic progression of glau comatous optic atrophy, even before perimetric changes occur.