Abstract

Objective: To evaluate which clinical parameters are the predictive factors associated with reversal of optic disc cupping in primary open-angle glaucoma. Methods: The medical records of 184 eyes of 184 patients with primary open-angle glaucoma were reviewed to detect the associated factors with reversal of optic disc cupping. Median follow-up time was 13.5 years (lower and upper quartiles: 11,18). Color stereo optic disc photographs were obtained repeatedly in all patients for qualitative and quantitative evaluation of disc damage. Reversal of the disc cupping was defined as a steady improvement of disc appearance on at least 3 consecutive disc examinations with the Disc Damage Likelihood Scale (DDLS) during the total follow-up period.

Results: The reversal of optic disc cupping was detected in 28 (15.2%) eyes. At baseline of the study, the degree of disc damage was significantly worse (P = 0.036, Mean Difference: -0.704, 95% Confidence Interval (CI): -1.362, -0.045) in the reversal group than in the non-reversal group. Both groups did not vary significantly in the time of total follow-up. Cox proportional hazard regression analysis demonstrated that reversal of optic disc cupping depended significantly on baseline disc damage (P = 0.022, Hazard Ratio (HR): 1.3, 95%CI: 1.1,1.6), but was independent of age, and the amount of intraocular pressure (IOP) difference between the first visit and the last visit in the same eye.

Conclusion: Baseline disc damage might be the predictive factor associated with the reversal of optic disc cupping in primary open-angle glaucoma.