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Incidence of non-glaucomatous ocular disease in patients with asymmetric optic disc cupping

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Abstract

Purpose

To evaluate the incidence of non-glaucomatous ocular disease in patients with asymmetric optic disc cupping.

Methods

A retrospective case series, including consecutive patients with cup-to-disc ratio (CDR) asymmetry greater than 0.2. All patients underwent a complete neuro-ophthalmological examination, automated perimetry with the Humphrey 24-2 visual fields program. Retinal nerve fibre layer thickness was measured by optical coherence tomography (OCT). The results of neuroimaging, macular OCT and blood tests were recorded as well. Patients were assigned a diagnosis of glaucomatous optic neuropathy (GON) or non-glaucomatous disease (NGD). The main outcome measure was the rate of non-glaucomatous ocular disease.

Results

A total of 120 (67 males) patients with a mean age of 71.1 ± 12.5 years met the inclusion criteria and were included in this study. The mean asymmetry in CDR between the eyes was 0.3 ± 0.13 (range, 0.2–0.9). Twenty patients (16.6%) had a visual field defect not typical for glaucoma and positive relative afferent pupillary defect was found in 24 patients (20%). Six patients were found to have newly diagnosed non-glaucomatous ocular disease: maculopathy in three patients, retinopathy in one patient and traumatic optic neuropathy in two patients. Patients with NGD were significantly younger than the patients with GON (59.8 ± 23.3 vs. 71.3 ± 11.5 years, P = 0.001). Optic disc pallor was found in 4/93 patients with glaucoma compared to 3/6 with newly diagnosed non-glaucomatous disease (4.7% vs. 50.0%, P = 0.03).

Conclusions

Asymmetric optic disc cupping can be associated with non-glaucomatous disease and may warrant neuro-ophthalmological evaluation, especially in younger patients or those with optic disc pallor.

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Acknowledgements

None.

Funding

No funding was received for conducting this study. The authors have no relevant financial or non-financial interests to disclose.

Author information

Author notes

  1. Omer Y. Bialer and Michael Mimouni have contributed equally to this paper.

Authors and Affiliations

  1. Department of Ophthalmology, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel

    Omer Y. Bialer, Gad Dotan, Iris Deitch & Dan D. Gaton

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Omer Y. Bialer, Gad Dotan, Iris Deitch, Gilad Rabina & Dan D. Gaton

  3. Ophthalmology Clinic, Clalit Health Services, Tel Aviv, Israel

    Omer Y. Bialer & Dan D. Gaton

  4. Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel

    Michael Mimouni

  5. Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Michael Mimouni

  6. Pediatric Ophthalmology Unit, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

    Gad Dotan

  7. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Gilad Rabina

Authors
  1. Omer Y. Bialer
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  2. Michael Mimouni
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  3. Gad Dotan
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  4. Iris Deitch
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  6. Dan D. Gaton
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by OYB, MM, GD, ID and GR. The first draft of the manuscript was written by OYB, MM, DDG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Authors are responsible for correctness of the statements provided in the manuscript.

Corresponding author

Correspondence to Michael Mimouni.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Rabin Medical Center institutional review board (IRB), Israel.

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Bialer, O.Y., Mimouni, M., Dotan, G. et al. Incidence of non-glaucomatous ocular disease in patients with asymmetric optic disc cupping. Int Ophthalmol 41, 2797–2804 (2021). https://doi.org/10.1007/s10792-021-01836-8

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  • DOI: https://doi.org/10.1007/s10792-021-01836-8

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