Abstract
Purpose
To investigate the long-term visual field (VF) progression of temporally tilted disc and nontilted disc in normal tension glaucoma (NTG).
Methods
Retrospective, observational case series. Forty-seven patients with temporally tilted disc (47 eyes), 44 patients with nontilted disc in NTG (44 eyes) patients, who were examined by at least 5 VF tests, and were followed-up over a 5-year period, at the Department of Ophthalmology of the Samsung Medical Center, from May 1998 to 2013. VF progression was defined by modified Anderson–Hodapp criteria, and Glaucoma Progression Analysis (GPA). Multivariate analysis was used to identify the risk factors for VF progression in the temporally tilted disc.
Results
According to the Anderson–Hodapp criteria, progression rates of the temporally tilted disc and nontilted disc at 60 months were 19% and 72%, respectively (P<0.0001). According to GPA, they were 25% and 53%, respectively (P<0.0001). Twenty of 47 patients in the temporally tilted disc did not show progression. Among them, the more tilted disc showed the more VF defects. The hazard ratio of retinal nerve fiber layer (RNFL) defect type was 3.08 (95% CI, 1.17–8.14; P=0.02). The simultaneous superior and inferior RNFL defect type was the most common in progressors in the temporally tilted disc (P=0.04).
Conclusion
Through long-term follow-up, the cumulative survival rate of temporally tilted disc was higher than that of nontilted disc. Caution is required in the treatment of the temporally tilted disc. New treatment policy for the temporally tilted disc may follow.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Tezel G, Trinkaus K, Wax MB . Alterations in the morphology of lamina cribrosa pores in glaucomatous eyes. Br J Ophthalmol 2004; 88: 251–256.
Quigley HA, Hohman RM, Addicks EM, Massof RW, Green WR . Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma. Am J Ophthalmol 1983; 95: 673–691.
Kim TW, Kagemann L, Girard MJ, Strouthidis NG, Sung KR, Leung CK et al. Imaging of the lamina cribrosa in glaucoma: perspectives of pathogenesis and clinical applications. Curr Eye Res 2013; 38: 903–909.
Wong TY, Klein BE, Klein R, Knudtson M, Lee KE . Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology 2003; 110: 211–217.
Sohn SW, Song JS, Kee C . Influence of the extent of myopia on the progression of normal-tension glaucoma. Am J Ophthalmol 2010; 149: 831–838.
Mitchell P, Hourihan F, Sandbach J, Wang JJ . The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology 1999; 106: 2010–2015.
Quigley HA, Anderson DR . Distribution of axonal transport blockade by acute intraocular pressure elevation in the primate optic nerve head. Invest Ophthalmol Vis Sci 1977; 16: 640–644.
Radius RL, Anderson DR . Rapid axonal transport in primate optic nerve. Distribution of pressure-induced interruption. Arch Ophthalmol 1981; 99: 650–654.
Doshi A, Kreidl KO, Lombardi L, Sakamoto DK, Singh K . Nonprogressive glaucomatous cupping and visual field abnormalities in young Chinese males. Ophthalmology 2007; 114: 472–479.
Park HY, Lee K, Park CK . Optic disc torsion direction predicts the location of glaucomatous damage in normal-tension glaucoma patients with myopia. Ophthalmology 2012; 119: 1844–1851.
Shields MB . Textbook of Glaucoma, 6th ed. Williams & Wilkins: Baltimore, 1998 pp 178–179.
Cho HK, Kee C . Comparison of the progression rates of the superior, inferior, and both hemifield defects in normal-tension glaucoma patients. Am J Ophthalmol 2012; 154: 958–968 e951.
Tay E, Seah SK, Chan SP, Lim AT, Chew SJ, Foster PJ et al. Optic disk ovality as an index of tilt and its relationship to myopia and perimetry. Am J Ophthalmol 2005; 139: 247–252.
You QS, Xu L, Jonas JB . Tilted optic discs: The Beijing Eye Study. Eye (Lond) 2008; 22: 728–729.
Khan KA, Dawson K, Mankowska A, Cufflin MP, Mallen EA . The time course of blur adaptation in emmetropes and myopes. Ophthalmic Physiol Opt 2013; 33: 305–310.
Kim JW, Chen PP . Central corneal pachymetry and visual field progression in patients with open-angle glaucoma. Ophthalmology 2004; 111: 2126–2132.
Chen PP . Correlation of visual field progression between eyes in patients with open-angle glaucoma. Ophthalmology 2002; 109: 2093–2099.
Rao HL, Kumbar T, Kumar AU, Babu JG, Senthil S, Garudadri CS . Agreement between event-based and trend-based glaucoma progression analyses. Eye (Lond) 2013; 27: 803–808.
Rao HL, Kumar AU, Babu JG, Senthil S, Garudadri CS . Relationship between severity of visual field loss at presentation and rate of visual field progression in glaucoma. Ophthalmology 2011; 118: 249–253.
Bengtsson B, Heijl A . A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol 2008; 145: 343–353.
Riise D . The nasal fundus ectasia. Acta Ophthalmol Suppl 1975; 126: 3–108.
Giuffre G . Tilted discs and central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 1993; 231: 41–42.
Lee J, Kim J, Kee C . Characteristics of patients with a localized retinal nerve fiber layer defect and normal optic disc appearance. Eye (Lond) 2012; 26: 1473–1478.
Hayreh SS, Jonas JB . Appearance of the optic disk and retinal nerve fiber layer in atherosclerosis and arterial hypertension: an experimental study in rhesus monkeys. Am J Ophthalmol 2000; 130: 91–96.
Dandona L, Quigley HA, Brown AE, Enger C . Quantitative regional structure of the normal human lamina cribrosa. A racial comparison. Arch Ophthalmol 1990; 108: 393–398.
How AC, Tan GS, Chan YH, Wong TT, Seah SK, Foster PJ et al. Population prevalence of tilted and torted optic discs among an adult Chinese population in Singapore: the Tanjong Pagar Study. Arch Ophthalmol 2009; 127: 894–899.
Sakata R, Aihara M, Murata H, Mayama C, Tomidokoro A, Iwase A et al. Contributing factors for progression of visual field loss in normal-tension glaucoma patients with medical treatment. J Glaucoma 2013; 22: 250–254.
Drance S, Anderson DR, Schulzer M . Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol 2001; 131: 699–708.
Lyu IJ, Lee JM, Kee C . Risk factors for rapid visual field progression in normal-tension glaucoma. J Korean Ophthalmol Soc 2012; 53: 996–1001.
Tenkumo K, Hirooka K, Baba T, Nitta E, Sato S, Shiraga F . Evaluation of relationship between retinal nerve fiber layer thickness progression and visual field progression in patients with glaucoma. Jpn J Ophthalmol 2013; 57: 451–456.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest
Additional information
Author contribution
Y-JC and CK designed the study; Y-JC, YK, JCH and CK conducted the study; Y-JC, YK and CK were involved in data collection and management, analysis and interpretation of data; Y-JC, YK and CK prepared, reviewed, and approved the manuscript. The present study was approved by the Institutional Review Board of Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. An exemption from informed consent for research was granted, because this was a retrospective research study.
Rights and permissions
About this article
Cite this article
Choy, YJ., Kwun, Y., Han, J. et al. Comparison of visual field progression between temporally tilted disc and nontilted disc, in patients with normal tension glaucoma. Eye 29, 1308–1314 (2015). https://doi.org/10.1038/eye.2015.17
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2015.17
This article is cited by
-
Optical coherence tomographic findings of glaucomatous eyes with papillomacular retinoschisis
Eye (2024)
-
Border tissue morphology is associated with macular ganglion cell thickness in open-angle glaucoma
Scientific Reports (2022)
-
Characteristics of progressive temporal visual field defects in patients with myopia
Scientific Reports (2021)
-
Posterior staphyloma is associated with the microvasculature and microstructure of myopic eyes
Graefe's Archive for Clinical and Experimental Ophthalmology (2021)
-
Association of Bruch’s membrane opening and optic disc morphology to axial length and visual field defects in eyes with primary open-angle glaucoma
Graefe's Archive for Clinical and Experimental Ophthalmology (2018)
