Differentiating Glaucomatous From Non-Glaucomatous Optic Nerve Cupping By Optical Coherence Tomography

Background With the improvement of living standards and scientific and techn-ological progress, glaucoma has become the major blinding eye disease. In clinical practice, the differentiation of glaucomatous from non-glaucomatous cupping can be difficult, even for experienced observers.Objective To evaluate the role of optical coherence tomography in differenting glaucomatous from non-glaucomatous optic nerve cupping in a cross-sectional pilot study.Methods Fifteen consecutive patients presenting to the First Affilated Hospital of Xianxiang Medical University from October2010to February2012with non-glaucomatous optic nerve cupping,18patients with glaucomatous optic nerve cupping and17persons with physiologic large cups. All patients underwent FD-OCT imaging:fast retinal nerve fiber layer (RNFL)3.4thickness, GCC and fast optic disc protocols. The differences in each group and between groups were analyzed by the statistical software SPSS16.0.Results There were no significant difference in average RNFL between patients with glaucomatous optic nerve cupping and patients with non-glaucomatous optic nerve cupping(P=0.343>0.05). Patients with non-glaucomatous optic nerve cupping had lower nasal and temporal RNFL thickness. Patients with glaucomatous optic nerve cupping had lower inferior and superior RNFL thickness. Patients with glaucomatous and non-glaucomatous optic nerve cupping had lower average, temporal, superior, nasal, inferior RNFL thickness compared to patients with physiologic large cups.There were significant difference in average, superior, inferior GCC among the three groups. Patients with glaucomatous and non-glaucomatous optic nerve cupping had lower average, superior, inferior GCC thickness compared to patients with physiologic large cups. Patients with glaucomatous had lower average, superior, inferior GCC thickness compared to patients with non-glaucomatous optic nerve cupping.Patients with glaucomatous optic nerve cupping had smaller rim area and rim volume compared to patients with physiologic large cups and non-glaucomatous optic nerve cupping. Patients with glaucomatous optic nerve cupping had lower cup disc horizontal ratio, and higer cup disc vertical ratio compared to patients with non-glaucomatous optic nerve cupping.Conclusion OCT appears to be a useful technology in differentiating glaucomatous from non-glaucomatous optic nerve cupping.