Verlaufsbeobachtung morphologischer und funktioneller Parameter bei verschiedenen Glaukomformen
Question: In this study we investigated the morphological and functional changes of glaucoma damage and how they interrelate in a follow-up of 2 years.Methods: 55 patients (29 male, 26 female) and 107 eyes (54 right, 53 left) at time-point 0 and after a follow-up of 2 years were examined. The morphological parameters were analysed using photos of the retina and functional changes using visual field analysis.Results: An increase of the parapapillary chorioretinal alpha and beta atrophy area was shown. Also the frequency of the beta atrophy area was increased. The vertical and horizontal Cup-to-Disc-Ration was increased both in the overall population and in the subgroups normal tension glaucoma and open angle glaucoma. The angle closure glaucoma showed an significant increase of the vertical diameter, whereas the horizonal diameter was increased in ocular hypertension. The Cup-to-disc ratio was increased in the overall population, in the subgroups normal tension glaucoma and open angle glaucoma. The neuroretinal rim shape was divided into four areas. The overall population showed a significant increase in all four areas. We found that the temporal horizontal area showed an increase in all subgroups, while the shape of the temporal inferior field was only different in the subgroup angle closure galucoma.The functional parameters only showed a deterioration for the open angle glaucoma in the white-white-perimetry. The angle closure glaucoma and the open angle glaucoma showed a significnat improvment of the mean deviation in the blue-yellow-perimetry.Conclusion: In contrast to the conspicuously changed morphological prameters, the functional parameters only showed a few changes. One possible explaination could be that the retina compensates defects using overlapping receptive fields, so that the visual field deficits are only recognized, when the ability of compensation is exhausted, while morphological defects are still recognized early on. An other reason is that morphological defects precede functional defects.All in all, the progress of the glaucomatous disease has to be detected and diagnosed using more than one parameter.
info:eu-repo/classification/ddc/610, Medizin, Glaukom, Gesichtsfeldmessung
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