%0 Journal Article
%T The role of clinical parapapillary atrophy evaluation in the diagnosis of open angle glaucoma
%A Joshua R Ehrlich
%A Nathan M Radcliffe
%J Clinical Ophthalmology
%D 2010
%I 
%R http://dx.doi.org/10.2147/OPTH.S12420
%X ole of clinical parapapillary atrophy evaluation in the diagnosis of open angle glaucoma Original Research (4116) Total Article Views Authors: Joshua R Ehrlich, Nathan M Radcliffe Published Date August 2010 Volume 2010:4 Pages 971 - 976 DOI: http://dx.doi.org/10.2147/OPTH.S12420 Joshua R Ehrlich, Nathan M Radcliffe Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA Purpose: To determine if clinical evaluation of parapapillary atrophy (PPA) significantly improves the ability to distinguish open-angle glaucoma (OAG) patients from glaucoma suspects. Methods: Patients in this study were under evaluation for glaucoma and had open angles, at least one reliable 24-2 SITA-standard automatic perimetry, and digital stereophotographs of the optic disc. PPA was identified clinically as a parapapillary region of absent (¦ÂPPA) or hyper/hypopigmented (¦ÁPPA) retinal pigment epithelium. A single masked observer evaluated photos for: vertical cup-to-disc ratio (CDR), clock hours of total and ¦ÂPPA, ¦ÂPPA as percentage width of the optic disc, presence or absence of ¦ÂPPA at each disc quadrant, and ordinal rating of total PPA. Generalized linear models were used to determine odds of an abnormal or borderline glaucoma hemifield test (GHT) as a function of PPA variables and covariates; model fit was assessed using the log-likelihood ratio test. Results: Of 410 consecutive patients, 540 eyes (of 294 patients) met inclusion criteria. Mean age was greater among patients with abnormal compared with normal GHT (P < 0.001), but sex and race/ethnicity did not differ between groups (P ¡Ý 0.22). Age, central corneal thickness (CCT) and CDR (P ¡Ü 0.006), but not intraocular pressure (IOP) (P = 0.71), were significant univariable predictors of the odds of an abnormal GHT. All PPA parameters significantly -predicted GHT (P ¡Ü 0.03), except presence of temporal ¦ÂPPA (P = 0.25). Adjustment for age, CCT, IOP, and CDR reduced the association between PPA and GHT, and model fit was not greatly improved by addition of PPA variables. Conclusions: Addition of most PPA parameters to a model already containing commonly assessed variables including age, CCT, IOP, and CDR does not significantly improve the ability to distinguish OAG patients from glaucoma suspects.
%K glaucoma
%K visual fields
%K parapapillary atrophy
%K optic nerve
%U https://www.dovepress.com/the-role-of-clinical-parapapillary-atrophy-evaluation-in-the-diagnosis-peer-reviewed-article-OPTH