SCIENTIFIC CORRESPONDENCE

Is the nasal optic disc sector important for morphometric glaucoma diagnosis?

J B Jonas and W M Budde

Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, and Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany

Correspondence to:
Correspondence to:
Dr J Jonas, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;
Jost.Jonas{at}augen.ma.uni-heidelberg.de

Background/aim: Since the central retinal vessel trunk usually located in the nasal optic disc sector can render difficult the delineation of the neuroretinal rim and optic disc, the aim of this study was to evaluate whether the nasal region of the optic nerve head is important, or can be left out, for the morphometric glaucoma diagnosis.

Methods: The clinical observational study included 1337 patients with primary or secondary open angle glaucoma and 649 normal subjects. The glaucoma group was divided into 1187 patients with glaucomatous visual field defects ("perimetric glaucoma"), and into 150 patients with optic nerve head changes and normal visual fields ("preperimetric glaucoma"). Colour stereo optic disc photographs were morphometrically evaluated.

Results: Highest diagnostic power for the separation between the normal group and the perimetric glaucoma group, and for the differentiation between the normal group and the preperimetric glaucoma group, had the sum of inferotemporal rim area plus superotemporal rim area, the sum of inferotemporal rim area plus superotemporal rim area plus temporal rim area, and the inferotemporal rim area as single parameter. The lowest diagnostic precision had the nasal rim area as single parameter or in combination with rim measurements in other disc sectors.

Conclusion: Excluding the nasal optic disc sector does not markedly decrease the diagnostic power of morphometric optic disc analysis in glaucoma diagnosis. It may have importance for an automated computerised morphometric detection of glaucomatous optic nerve damage.

Keywords: confocal laser scanning tomography; neuroretinal rim; optic disc; optic nerve head

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