Relationship between parapapillary atrophy and visual field abnormality in primary open-angle glaucoma

Measurement of autofluorescence in the parapapillary atrophic zone in patients with ocular hypertension

“…That area and extension of parapapillary atrophy is correlated with morphologic and functional glaucomatous damage could be shown in a large number of studies [6,17,18,21,39]. Clinico-histological correlation and experimental studies confirmed this clinical observation [10,24,25].…”

“…Histologically, vacuoles, cell atrophy and lipofuscin accumulation can be recognized beside an inhomogenous distribution of melanin granules in the retinal pigment epithelium, whereas parapapillary atrophic zone beta shows complete loss of retinal pigment epithelium as well as marked reduction of photoreceptors and rarification of chorioidal vessels [17,24,25]. Progression of parapapillary atrophic zone beta (atrophic zone alpha turns into beta) is correlated with progression of the morphologic glaucomatous damage [17,32] and visual field loss [18,21]. Fundus autofluorescence can be seen at the border of parapapillary atrophic zone alpha.…”

Emerging risk factors for glaucoma onset and progression

“…The association between beta-zone PPA and glaucoma is independent of ethnicity ( Jonas, 2005), results in an absolute scotoma because of loss of retinal pigment epithelium and photoreceptors Kono et al, 1999), and is not associated with any other vascular optic neuropathy. The region of the widest beta zone often appears at the region of the thinnest neuroretinal rim ) is more often accompanied by DH (Ahn et al, 2004;Radcliffe et al, 2008) and corresponds to the area of VF loss.…”

Predictive Factors Within the Optic Nerve Complex for Glaucoma Progression

“…Among glaucomatous eyes with focal VF loss, there is good agreement between the affected area of the field and the location of APPA. 50,51 Moreover, Kono et al 51 showed a significant correlation between APPA area measured with confocal scanning laser ophthalmoscopy and the VF mean deviation (MD) and corrected pattern standard deviation (CPSD). These studies support the hypothesis that there is an intrinsic association between the presence and extent of APPA and the severity of glaucoma.…”