Parapapillary atrophy in patient with focal viual field lo Original Reearch Article

PURPOE: To examine parapapillary atrophy in normal ubject and patient with primary open-angle glaucoma with focal viual field lo. METHOD: Twenty-nine patient with repeatable early focal viual field lo according to tandard automated perimetry (Humphrey program 24-2) and 29 matched (age and dik area) normal ubject were included. Parapapillary atrophy area and optic dik topography were evaluated with a confocal canning laer ophthalmocope. The difference in parapapillary atrophy area between normal ubject and patient with glaucoma wa examined. Optic dik topography wa evaluated by mean of the rim-dik area ratio in 36 10-degree ector and claified into diffue and focal pattern of neuroretinal rim thinning. In patient with a focal pattern, the location of rim thinning and parapapillary beta zone atrophy were compared. REULT: Beta zone atrophy wa detected more frequently in patient with glaucoma (45% [13/29]) than in normal ubject (7% [2/29]), and it wa located both uperiorly and inferiorly in 92% (12/13) of the glaucoma patient. Alpha zone atrophy wa ignificantly larger in patient with glaucoma than normal ubject (P = .009) but not more frequent (97% [28/29] in both group). ixty-one percent (8/13) of glaucoma patient with beta atrophy had diffue thinning and 31% (4/13) had focal thinning. Eight percent (1/13) did not have neuroretinal rim thinning. In the four patient with both focal rim thinning and beta zone atrophy, the location of rim thinning correponded to the location of the beta zone atrophy (100% [4/4]). CONCLUION: In patient with early focal glaucomatou viual field lo, the preence and location of parapapillary beta zone atrophy and neuroretinal rim thinning are in good correpondence. Obervation of localized parapapillary beta zone atrophy in clinical practice hould direct one to more cloely examine the optic dik in thi region, a it may reveal localized rim thinning in a dik previouly conidered to be normal. Moreover, diffue tructural change in an eye with only focal functional change, a determined by tandard automated perimetry, i conitent with the poibility that tructural damage may be more widepread than functional damage in thee patient.