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Optic nerve head cupping in glaucomatous and non-glaucomatous optic neuropathy
  1. Masoud Aghsaei Fard1,
  2. Sasan Moghimi1,
  3. Alireza Sahraian1,
  4. Robert Ritch2
  1. 1 Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2 Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York City, New York, USA
  1. Correspondence to Dr Masoud Aghsaei Fard, Farabi Eye Hospital, Eye Research Center, Tehran 13352, Iran; masood219{at}


Background Enlargement of optic disc cupping is seen both in glaucoma and in neurological disorders. We used enhanced depth imaging with spectral-domain optical coherence tomography to differentiate glaucoma from non-glaucomatous optic neuropathy.

Methods The optic discs were scanned in this prospective comparative study, and the lamina cribrosa (LC) thickness and anterior laminar depth (ALD) in the central, superior and inferior optic nerve head, and peripapillary choroidal thicknesses, were measured.

Results There were 31 eyes of 31 patients with severe glaucoma and 33 eyes of 19 patients with non-glaucomatous cupping. Eyes of 29 healthy controls were also enrolled. There was no significant difference in the cup-to-disc ratio and in the average peripapillary nerve fibre layer thickness between the glaucoma and non-glaucomatous cupping groups (p>0.99). The average peripapillary choroidal thickness was thinner in glaucoma eyes than in the control eyes after adjusting for age and axial length. Glaucomatous and non-glaucomatous eyes had greater ALD and thinner LC than the control eyes (p<0.001 for both). ALDs of glaucoma eyes were deeper than non-glaucomatous eyes (p=0.01 for central ALD) when age, axial length and peripapillary choroidal thickness were included in the linear mixed model. Prelaminar thickness and LC thickness of glaucoma eyes were not different from non-glaucomatous eyes after adjusting.

Conclusion Deeper ALD was observed in glaucoma than non-glaucomatous cupping after adjusting for choroidal thickness.

  • glaucoma
  • nonglaucomatous cupping
  • laminar depth
  • lamina cribrosa
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  • Contributors MAF: design, analysis, writing. SM: analysis, data collection. AS: data entry, data collection. RR: supervision, design, final review.

  • Funding Supported in part by the Michael and Francesca Freedman Glaucoma Research Fund of the New York Eye and Ear Infirmary of Mount Sinai.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Ethics Committee of Tehran University of Medical Science (code number: 9311257008), and all investigations adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Excel data are available.

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