Optic Disc Changes with the Progression of Glaucomatous Visual Field Damage

Abstract

It is not clearly defined yet whether the early glaucomatous visual field damage originates in vasogenic or mechanical changes at the optic disc.

In the present study, we determined whether changes occur in fluorescein angiographic filling pattern and in cup size change with the development of new visual field damage. Our subjects comprised three ocular hypertensive and five primary open angle glaucoma patients.

For the purpose of exact determination of cupping changes to visual field correlation, we employed cup-to-disc area ratio (C/D.A.) at each side of the disc (upper and lower).

The change of cup size (C/D.A.) provided a direct correlation to newly developed visual field damage especially in early stage glaucoma, while angiographic filling defects could not provide a good correlation to visual field in ocular hypertension and early stage glaucoma.

From these results it would be surmised that. the fluorescein angiographic disc capillary dropout is a secondary event after nerve fiber loss has begun to occur.