Figure 4
Representative Case No. 3 in the Glaucoma Conversion Group. Serial fundus photographs (A: 2003; B: 2009; C: 2011; D: 2016) of the right eye of 53-year-old woman with baseline intraocular pressure (IOP) of 14 mmHg. Note the large optic disc cupping (vertical cup-to-disc ratio [CDR] = 0.61) with vertical cupping and violation of the ISNT rule without retinal nerve fiber layer defect (RNFLD) at baseline. The disc ovality, peripapillary atrophy area-to-disc area ratio, and central retinal vessel trunk nasalization were 1.11, 0.06, and 73%, respectively. The baseline risk score was 9.68 (A). Initial disc hemorrhage (DH, arrow) developed at the inferotemporal neuroretinal rim and increased CDR with the thinning of inferotemporal RNFL was suspected (B). The definite RNFLD (outlined by arrowheads) was first detected at the inferotemporal region 2 years later with the concurrent DH (arrow) (C). The RNFL showed a progressive thinning afterward, with definite loss of the inferotemporal neuroretinal rim (D). During the follow up period from November 2003 to January 2016, the mean IOP was 13.5 mmHg with the IOP fluctuation of 1.3 mmHg and peak IOP of 15 mmHg.
