Literature DB >> 24985480

Optic disc tilt direction determines the location of initial glaucomatous damage.

Jin A Choi1, Hae-Young Lopilly Park2, Hye-Young Shin3, Chan Kee Park2.   

Abstract

PURPOSE: To explore differences in optic disc tilt and torsion between normal control and glaucoma subjects, and to determine whether the direction of optic disc tilt is consistent with the initial location of glaucomatous visual field (VF) defect.
METHODS: Glaucoma patients with isolated superior or inferior hemifield loss (n = 136) and normal controls (n = 99) were analyzed. Disc ovality index and torsion degree were measured on retinal photographs. Imaging of optic disc was obtained using Heidelberg retinal tomography (HRT) III and Cirrus spectral-domain optical coherence tomography (OCT). The degree of temporal disc tilt was assessed using horizontal topographic images and vertical (upward or downward) disc tilt using vertical topographic images, respectively.
RESULTS: In all subjects, disc ovality was significantly associated with HRT- and OCT-measured temporal disc tilt and axial length (AL) (all P < 0.001), whereas disc torsion degree was associated with HRT- and OCT-measured vertical disc tilt and AL (all P < 0.05). Association of AL with disc ovality and torsion became more evident as the mean deviation increased. When data on glaucoma patients with superior and inferior hemifield defects were compared, the vertical disc tilt (HRT- and OCT-assessed, P < 0.001 and 0.030, respectively) and the torsion degree (P = 0.002) differed significantly. Upon multivariate logistic regression analysis, the HRT-measured vertical disc tilt was an independent factor determining initial location of the VF defect (P = 0.012).
CONCLUSIONS: Measurement of vertical disc tilt may give valuable information about the superior versus inferior regional susceptibilities of glaucoma. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Entities:  

Keywords:  disc tilt; disc torsion; optic disc; retinal nerve fiber layer defect; susceptibility

Mesh:

Year:  2014        PMID: 24985480     DOI: 10.1167/iovs.14-14663

Source DB:  PubMed          Journal:  Invest Ophthalmol Vis Sci        ISSN: 0146-0404            Impact factor:   4.799


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