Abstract

SO.15.05

Optic disc size and glaucoma

Hoffmann E. M.¹, Weinreb R. N.², Pfeiffer N.^1
1Universitäts-Augenklinik Mainz; ²Hamilton Glaucoma Center, UC San Diego, USA

Detection of characteristic glaucomatous optic disk damage involves the measurement of the size and shape of the neuroretinal rim and optic cup. Assessment of optic disk size is an important component of optic nerve examination as the size of the neuroretinal rim and the optic cup vary with disk size. Several factors make the determination of whether disk size is an independent risk factor for glaucoma susceptibility difficult. First, measurement techniques can provide different estimates of disk size limiting comparison among studies. Second, there is a large variation in disk size within a population and also among populations. Third, disk size itself may influence the likelihood that a clinician makes a diagnosis of glaucoma, thus providing a potential source of bias. It is often easier to detect a glaucomatous appearing optic nerve head if the disk is large compared to one that is small. If disk size is in fact an independent risk factor for the development of glaucoma, it is relevant to consider the anatomical features that are responsible for the increased susceptibility. This paper addresses the impact of measurement technique and population characteristics on reported optic disk size. In addition, the influence of disk size on the appearance of the optic disk and nerve fiber layer and how this may relate to glaucoma susceptibility is discussed.

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