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Longtime Variability of Optic Disc Morphometry Measured with the HRT in Glaucoma Eyes and Suspects without Progression

Mardin C. Y., Jünemann A., Nguyen N. X., Viestenz A., Horn F. K.,
Friedrich-Alexander-Universität, Augenklinik (Erlangen)

Purpose: To investigate the longtime variability of planimetric and volumetric measurements with the HRT I (Heidelberg Engineering, Dossenheim) in glaucoma patients and suspects without clinical signs of progression.
Methods: 35 eyes with ocular hypertension (OHT), 29 eyes with preperimetric and 21 eyes with manifest open-angle glaucoma from the Erlangen Glaucoma Registry were examined by by slit-lamp biomicroscopy, gonioscopy, static perimetry, tonometry and morphology of the optic disk (planimetry; HRT I, Heidelberg Engineering, Dossenheim). Time interval for five follow-up examinations ranged from 1294 to 2555 days, mean 1700 days. All eyes had to show a stable disk morphology and perimetry over this time. A regression line was calculated for each patient over five examinations for each HRT variable (area and volume of the neuroretinal rim (NRR) and cup, cup shape measure) and the difference (delta) was calculated between the first and last examination.
Results: Perimetrically all eyes showed a significant improvement of the visual field’s mean defect (p<0.01). Disk area varied in all eyes by +0.002 to 0.023mm², the NRR by +0.015mm² in OHT and by -0.022mm² in eyes with glaucomatous optic discs. Area and volume of the cup decreased by -0.008mm² bzw -0.001mm³ in OHT, and increased by 0.026mm² and 0,006mm³ respectively in the preperimetric and by 0.045mm² and 0.015mm³ respectively in the perimetric group. Mean delta of all variables varied between 1 and 4% of the first measurement and was statistically not significant in either group.
Conclusions: In contrast to glaucoma eyes with morphological signs of deterioration1), eyes without clinical deterioration show no significant change of the HRT variables between the first and last examination after five years follow-up. Stable patients and suspects seem to show a morphometric variability of the NRR area by 1.7% and cup area by 3.2% in contrast to instable patients with 4% and 10% respectively1).
1) Mardin et al. Morphometric changes in optic discs with morphologic progression of the glaucomatous optic atrophy measured with Laser-Scanning-Tomography. Klin Monatsbl Augenheilkd 2000; 217: 82-87 Supported by SFB 539