Abstract
•Background: To test the intra-observer, intra-photographic variability of two-dimensional measurements of the optic nerve head we used computer-assisted planimetry. Depending on the variability, we calculated the confidence intervals of the optic disc parameters which could be indicative of glaucomatous damage on follow-up.
•Methods: Slides of the optic disc were taken from 10 eyes of 10 patients (n = 6 open angle glaucoma, n = 4 ocular hypertension) using a Zeiss fundus camera. All eyes were evaluated 10 times within a random sequence on 10 different days. We obtained the absolute values of the disc radii and the cup radii in steps of 1, 10, and 45 deg in predefined quadrants and the mean radii.
•Results: The confidence interval of the cup radius on follow-up, depending on sector size, ranged between 62 and 38 % for small cups (radius 0.2 mm) and between 12 and 7% for large cups (radius 0.8 mm). The confidence intervals of the cup/disc ratio distinguishable from the disc boundary, depending on sector size, ranged between 0.81 and 0.89 for small discs (radius 0.5 mm) and from 0.90 to 0.94 for large discs (radius 1.0 mm). The confidence intervals of the cup/disc ratio indicating an increase on the cup radius in follow-up, distinguishable from the boundary of the disc, ranged, depending on sector size, between 0.57 and 0.75 for small discs (radius 0.5 mm) and from 0.81 to 0.89 for large discs (radius 1.0 mm). 9 Conclusion: The smaller the disc, the more difficult is the detection of glaucomatous damage, and the larger the cup, the more difficult is the detection of progression of glaucomatous damage.
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References
Airaksinen PJ, Drance SM, Douglas GR, Schulzer M (1985) Neuroretinal rim areas and visual field indices in glaucoma. Am J Ophthalmol 99:107–110
Anderson DR (1975) Pathogenesis of glaucomatous cupping: a new hypothesis. In: Symposium on glaucoma. Mosby, St. Louis, p 81
Betz P, Camps F, Collignon-Brach C, Lavergne G, Weekers R (1982) Biometric study of the disc cup in open-angle glaucoma. Graefe's Arch Clin Exp Ophthalmol 218:70–74
Burk ROW (1991) Die dreidimensionale Biomorphometrie der Papille unter besonderer Berücksichtigung der glaukomatösen Optikusschädigung. Eine Strukturanalyse mittels der Laser Scanning Tomographie. Doctoral thesis, University of Heidelberg
Caprioli J, Miller JM, Sears M (1987) Quantitative evaluation of the optic nerve head in patients with unilateral visual field loss from primary openangle glaucoma. Ophthalmology 94:1484–1487
Cioffi GA, Robin AL, Eastman RD, Perell HF, Sarfarazi FA, Kelman SE (1993) Confocal laser scanning ophthalmoscope — reproducibility of optic nerve head topographic measurements with the confocal laser scanning ophthalmoscope. Ophthalmology 100:57–62
Cloux-Fey U, Gloor B, Jaeggi P, Hendrickson P (1986) Papille und Gesichtsfeld beim Glaukom. Klin Monatsbl Augenheilkd 189:92–103
Dannheim F (1988) Vergleich manueller und computergestützter Papillenanalysen beim chronischen Glaukom. Fortschr Ophthalmol 85:445–447
Funk J (1990) Increase of neuroretinal rim area after surgical intraocular pressure reduction. Ophthalmic Surg 21:585–588
Hendrickson P (1992) Über Fehlerquellen bei der Planimetrie des Sehnerven. Klin Monatsbl Augenheilkd 200:489–493
Jonas JB (1989) Biomorphometrie des Nervus opticus. In: Naumann GOH, Merte HJ, Hollwich F, Gloor B (eds) Bücherei des Augenarztes. Enke, Stuttgart pp 1–184
Jonas JB, Fernandez MC, Stürmer J (1993) Pattern of glaucomatous neuroretinal rim loss. Opthalmology 100:63–68
Kottler MS, Rosenthal AR, Falconer DG (1976) Analog vs. digital photogrammetry for optic cup analysis. Invest Ophthalmol 15:651–654
Nagin P, Schwart B, Katsuhiko N (1985) The reproducibility of computerized boundary analysis for measuring optic disc pallor in the normal optic disc. Ophthalmology 92:243–251
Pyott AAE, Montgomery DMI (1993) Interobserver variation in clinical optic disc biometry. Eye 7:452–456
Quigly HA, Addicks EM, Green WR, Maumenee AE (1981) Optic nerve damage in human glaucoma. II. The site of injury and susceptibility to damage. Arch Ophthalmol 99:635–649
Quigly HA, Addicks EM, Green WR (1982) Optic nerve damage in human glaucoma. III. Quantitative correlations of nerve fiber loss and visual field defect in glaucoma, ischemic optic neuropathy, papilledema, and toxic neuropathy. Arch Ophthalmol 100:135–146
Quigley HA, Dunkelberger GR, Green WR (1989) Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol 107:453–464
Rohrschneider K, Burk ROW, Völker HE (1993) Reproducibility of topometric data acquisition in normal and glaucomatous optic nerve heads with the laser tomographic scanner. Graefe's Arch Clin Exp Ophthalmol 231:457–464
Schwartz JT (1976) Methodological differences and measurement of the cup/disc ratio. Am J Ophthalmol 94:1011–1015
Shields MB, Martone JF, Shelton AR, Ollie AR, MacMillan J (1987) Reproducibility of topographic measurements with the optic nerve head analyzer. Am J Ophthalmol 104:581–586
Shirakashi M, Nanba K, Iwata K (1991) Changes in reversal of cupping in experimental glaucoma — longitudinal study. Ophthalmologica 202:194–201
Sogano S, Tomita G, Kitazawa Y (1993) Changes in retinal nerve fiber layer thickness after reduction of intraocular pressure in chronic open-angle glaucoma. Ophthalmology 100:1253–1258
Stürmer J, Poinoosawmy D, Broadway DC, Hitchings RA (1992) Intraand inter-observer variation of optic nerve head measurements in glaucoma using disc-data. Int Ophthalmol 16:227–233
Wilms KH (1986) Zur Struktur einfacher Programme zur Berechnung von absoluten Größen des Augenhintergrundes. Optometrie 4:204–206
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Bartz-Schmidt, K.U., Sündtgen, M., Widder, R.A. et al. Limits of two-dimensional planimetry in the follow-up of glaucomatous optic discs. Graefe's Arch Clin Exp Ophthalmol 233, 284–290 (1995). https://doi.org/10.1007/BF00177650
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DOI: https://doi.org/10.1007/BF00177650