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Large optic nerve heads: megalopapilla or megalodiscs

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Abstract

Purpose: To evaluate megalopapillas in order to determine whether they constitute a different population, according to their specific features.Material: Evaluation of the optic nerve head of 405 eyes divided into 172 normal eyes, 168 pre-perimetric glaucomas (phase 3 or 4), 30 primary congenital glaucomas (children with pure congenital glaucomas operated more than once and diagnosed within the first year of age), and 35 megalopapillas.Method: The examinations were performed with the HRT (Heidelberg Retina Tomograph), using a wavelength of 680 nm and the new standard reference plane. Each examination results from the mean of 3 image acquisitions with a SD lower than n = 20. Each optic nerve head was studied in 360 degrees (segments), as well as in quadrants and octants separately (predefined segments). The visual fields wereassessed with either the Octopus 1-2-3 or the Octopus 101, programs G2 and G2x (three complete phases). The intraocular pressure was measured by means of daily pressure curves including 7 measurements with applanation tonometry at the office and the first one at 6/7 a.m. with the patient still in bed. Gonioscopic examinations were also performed for classification purposes.Results: By comparing all the stereometric parameters with the Total Area (disc area) and the Rim Volume it has been concluded that the megalopapilla group is different from both the normal control group and the glaucoma group. The disc area of the congenital glaucomas was not statistically different from the megalopapillas,but it was in terms of rim volume and other parameters.Conclusion: megalopapilla is an entity characterized by a large optic nerve head which may appear abnormal, with an increased cup, but associated with a normal rim volume, normal visual field and normal IOP. Special attention should be given to its differentiation from pseudoglaucomatous diseases.Discussion: The frequency of megalopapillas seems to be quite higher than incongenital optic nerve head anomalies, but is has been virtually ignored by the literatureworldwide so far.

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References

  1. Franceschetti A, Bock R. Megalopapilla. A new congenital anomaly. Amer J Ophthalmol 1950; 33: 227–235.

    Google Scholar 

  2. Brodsky CM. Congenital optic disk Anomalies. Survey of Ophthalmol 1994; 39: 89–112.

    Google Scholar 

  3. Goldhammer Y. Optic nerve anomalies in basal encephalocele. Arch Ophthalmol 1975; 2: 115–118.

    Google Scholar 

  4. Theodossiadis GP, Kollia AK, Theodossiadis PG. Cilioretinal arteries in conjunction witha pit of the optic disc. Ophthalmologica 1992; 204: 115–121.

    Google Scholar 

  5. Caprioli J. Basal encephalocele and Morning Glory syndrome. Br J Ophthalmol 1989; 107: 145–150.

    Google Scholar 

  6. Sampaolesi R, Sampaolesi JR. Etude du nerf optique dans le glaucome congénital par la tomographie confocale au laser. Ophtalmologie 1998; 12: 205–213.

    Google Scholar 

  7. Grimson BS, Perry DD. Enlargement of the optic disk in childhood optic nerve tumors. Amer J Ophthalmol 1984; 97: 627–631.

    Google Scholar 

  8. Collier M. Megalopapilla and central pulverulent cataract. Bull Soc Franc Ophtalmologie 1965; 9: 719–724.

    Google Scholar 

  9. Hirokane K, Kimura T, Kimura W, Sawada T, Ohte A, Kobayashi M. Megalopapilla in four children. Folia Ophthalmol JPN 1995; 731–735.

  10. Jonas JB, Zäch FM, Gusek GC and Naumann GOH. Pseudoglaucomatous physiologic large cups. Amer J Ophthalmol 1989; 107: 137–144.

    Google Scholar 

  11. Maisel JM, Pearlstein CS, Adams WH, Heotis PM. Large optic disks in the Marshallese Population. Amer J Ophthalmol 1989; 107: 145-150.

    Google Scholar 

  12. Sampaolesi R. Congenital glaucoma. The importance of echometry in its diagnosis, treatment and functional outcome. In Cennamo G and Rosa N (eds) Ultrasonography in Ophthalmology XV, Proceedings of the 15th SIDUO Congress, Cortina, Italy, 1994, Kluwer Academic Publishers, Dordrecht, 1997: 1–47.

    Google Scholar 

  13. Saruhan A, Orgül S, Koçak I, Prünte C, Flammer J: Descriptive information on topographic parameters computed at optic nerve head with Heidelberg Retina Tomograph. J Glaucoma 1998; 7: 420–429.

    Google Scholar 

  14. Burk ROW, Rohrschneider K, Noack H, Völcker HE: Are large optic nerve heads susceptible to glaucomatous damage at normal intraocular pressure? Graefes Arch Ophthalmol 1992; 230: 552–560.

    Google Scholar 

  15. Sampaolesi R, Sampaolesi JR: Tomografía confocal del nervio ó ptico y de la retina (Relato Anual). Arch Oftalmol B Aires 1995; 70: 1–566.

    Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, University of Buenos Aires, School of Medicine, Buenos Aires, Argentina

    Roberto Sampaolesi & Juan Roberto Sampaolesi

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  1. Roberto Sampaolesi
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  2. Juan Roberto Sampaolesi
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Sampaolesi, R., Sampaolesi, J.R. Large optic nerve heads: megalopapilla or megalodiscs. Int Ophthalmol 23, 251–257 (2001). https://doi.org/10.1023/A:1014409404579

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  • DOI: https://doi.org/10.1023/A:1014409404579

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