Structural changes of the optic nerve and nerve fiber layer in early glaucoma

Thursday, Sep 24, 1992 La Palms/A

X ICER Abstracts

coDEzLoc-2

SEFl'EMBER24/THURSDAY

CHAIRPERSONS:

NICOLA

STRUCTURAL CHANGES OF THE OPTIC NERVE AND NERVE FIBER LAYER IN EARLY GLAUCOMA. Joseph Caprioli, Yale University Department of Ophthalmology and Visual Science, New Haven, CT 06510. The evaluation of glaucoma treatment requires sensitive and specific markers for early damage. Fifteen patients with early, asymmetrical primary open angle glaucoma were carefully followed for an average of 6.1 years. Progressive disc damage was detected in 8 of 15 eyes without initial visual field loss; only 2 of these a eyes developed field loss. In another study, we compared the diagnostic precision (the ability to correctly ider.ify normal or glaucoma) of qualitative disc evaluation, qualitative NFL evaluation, quantitative optic disc measurements, and quantitative NFL height measurements in 50 normals, and 134 glaucoma patients with early field loss. The diagnostic precision of subjective disc evaluation was superior to subjective NFL evaluation: NFL height measurements were superior to measurements of cup/disc ratio, cup volume, and rim area. While qualitative evaluations are sensitive to abnormalities, quantitative measurements are required to measure rates of change at different stages of the disease, and to provide reproducible, measurable outcome parameters for clinical studies.

ORZALESl(ITALY)

JOSEPHCAPRlOGLI(USA)

s of the WC Eika her in Earlv I. Caprioli (USA)

Nerve

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~~-Q~ular H-es with Tim&l Therw B. Schwartz. T. Takamoto, P. Lavin and G. Smits (USA) SW Nem Head S.S. Hayreh (USA)

I.E. Gnmwald

570

1

IAGNOSIS AND

Flow in ci.lawm

(USA)

es on Aoueous M.L. Sears (USA) 12:15

INCREASE OF RETINAL NERVE FIBER LAYER THICKNESS IN OCULAR HYPERTENSIVES WITH TIMOLOL THERAPY by Bernard Schwartz., M.D., Ph.D.: Takenorl Taksmoto. Ph.D.; Phillip Lavin, Ph.D.; and Gerard Smuts. Ph.D. I Tufts University School of Medicine and Harvard School of Medicine, Boston. Mass.. USA.

12:30 E.1. Higginbotham 12:45

571

2

Timolol in Gelritcm M. Goethals (Belgium) (USA)

Discussion

Thirty-seven ocular hypertensive6 were randomly assigned to placebo or 0.5% tlmolol drops to both eyes in a double masked clinical trial. Mersurements of ocular pressure and photographs of retinal nerve fiber layer were made at about 3 month intervals for 18 to 24 months of follow-up. None of the subjects developed visual field 108s when tested with the Goldmann perimeter by kinetic and static means at SIX month intervals. Subjects treated with timolol had a significant decrease in ocular pressure and developed a significant increase in retinal nerve fiber layer thickness compared to subjects treated with placebo. Multivariate retinal associated Timolol retinal timolol than the

analyses indicated that the increase nerve fiber layer thickness was not with the decrease in ocular pressure. treatment was associated with the increase This effect nerve fiber layer thickness. appears to be &elated to mechanisms other decrease in ocular pressure.

of of

572

3 OPTIC

YEfWE

Department

of

HEAB

Ophthalmology, Iowa city.

A large body that glauooaatous vascular disorder is multifactorial

BLOOD

PLOW

Iowa,

IN

GLAUCGM

University VSA

of

Iowa,

of evidenoe strongly suggests optic neuropathy represents 5 of the optic nerve head, which in nature.

Blood flow in the optic nerve head depends the~~~ follouina in its blood VwSd6: Perfusion p&sure (wan blood pressure minus intraocular preseure). 2. Vasoulsr resistance. 3. Autoreguletion of blood flow. The blood flow in ttm optic nerve head is aluo influanoed by the location of tlte watershed xones of posterior ciliary artery circulation in relation to the nerve head.

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