Differentiating Glaucomatous from Non-Glaucomatous Optic Nerve Cupping by Optical Coherence Tomography



Preeya K Gupta 1, Sanjay Asrani 1, Sharon F Freedman 1, Mays El-Dairi #, 1, M Tariq Bhatti*, #, 1, 2
1 Departments of Ophthalmology Duke University Eye Center and Duke University Medical Center, USA
2 Medicine (Division of Neurology), Duke University Eye Center and Duke University Medical Center, USA


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© Gupta et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Departments of Ophthalmology and Medicine (Division of Neurology), 2351 Erwin Road, Duke University Eye Center, DUMC 3802, Durham, NC 27710-3802, USA; Tel: 919.681.9191; Fax: 919.684.0547; E-mail: tariq.bhatti@duke.edu
# These authors have contributed equally.


Abstract

Background:

In clinical practice, the differentiation of glaucomatous from non-glaucomatous cupping can be difficult, even for experienced observers. The purpose of this study was to evaluate the role of optical coherence tomography (OCT) in differentiating glaucomatous from non-glaucomatous optic nerve cupping in a cross-sectional pilot study.

Methods:

Eleven consecutive patients presenting to the Duke Eye Center from September 2007 to July 2008 with non-glaucomatous optic nerve cupping and 12 patients with glaucomatous optic nerve cupping were identified. All patients underwent Stratus® OCT imaging: fast macular map, fast retinal nerve fiber layer (RNFL) 3.4 thickness, and fast optic disc protocols. Automated visual field perimetry was performed on the date of OCT scan in non-glaucomatous cupping patients, and from 0-9 months of scan date in glaucoma patients. Eyes were matched by optic nerve cup-to-disc area ratio; average and mean deviation were calculated for each variable.

Results:

For a similar average RNFL, patients with non-glaucomatous optic nerve cupping had lower nasal and temporal RNFL thickness, as well as lower macular thickness and volume compared to patients with glaucomatous optic nerve cupping.

Conclusion:

OCT appears to be a useful technology in differentiating glaucomatous from non-glaucomatous optic nerve cupping. The pattern of RNFL loss appears more diffuse in non-glaucomatous optic nerve cupping compared to glaucomatous optic nerve cupping. Future studies with larger sample size and specific neuro-ophthalmic causes of optic nerve cupping may further elucidate the role of OCT in this clinical setting.

Keywords: Optic nerve cupping, non-glaucomatous optic nerve cupping, OCT.