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Quantification of Neuroretinal Rim Loss Using Digital Planimetry in Long-term Follow-up of Normals and Patients With Ocular Hypertension

Laemmer, Robert MD*; Schroeder, Sabine MD*; Martus, Peter PhD; Viestenz, Arne MD* ‡; Mardin, Christian Y. MD*

doi: 10.1097/IJG.0b013e31804a5e80
Original Studies

Purpose The purpose of this study was to investigate if digital planimetry is appropriate for quantification of neuroretinal rim loss in patients with ocular hypertension (OHT) and if there is an age-related neuroretinal rim loss in normals.

Patients and Methods Fifty-six patients with OHT without optic disc change, 13 patients with OHT and conversion to early glaucoma during follow-up and 42 age-matched controls were recruited from the Erlangen Glaucoma Registry. Annually, all patients underwent complete ophthalmologic examination including detailed diagnostic testing concerning glaucoma. Gold standard for morphologic evaluation of the optic nerve head was the semiquantitative 2-dimensional-method described by Jonas. Optic disc images from baseline and after 5 or 10 years follow-up were used for digital planimetry. Optic disc area and cup area were measured using commercial software: Soft Imaging System analysis. The investigator was masked for diagnosis and time point of examination.

Results Mean neuroretinal rim loss was 0.36% per year in controls, 0.54% per year in patients with OHT without progressive disease, and 0.95% per year in OHT and conversion.

Conclusions Neuroretinal rim loss was highest in the group of OHT with conversion to early glaucoma during follow-up. In the control group we detected a very low mean neuroretinal rim loss during 10-year follow-up. In ocular hypertensive patients without progressive disease mean neuroretinal rim loss was approximately twice compared with normals.

*Department of Ophthalmology, University of Erlangen-Nuremberg

Institute of Biostatistics and Clinical Epidemiology, Charité University Medicine, Berlin

Department of Ophthalmology, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany

Supported by Deutsche Forschungsgemeinschaft SFB 539 “Glaukome und Pseudoexfoliationssyndrom.”

Reprints: Robert Laemmer, MD, Department of Ophthalmology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany (e-mail:

Received for publication May 19, 2006; accepted February 11, 2007

© 2007 Lippincott Williams & Wilkins, Inc.