Title: An Observational Study Comparing the Correlation of Vertical Cup Disc Ratio and Disc Damage Likelihood Scale with Visual Field Changes and Central Corneal Thickness in Primary Open Angle Glaucoma Patients
Authors: Shashwat Bhattacharyya, Aditi Maitra, Ramkrishna Mandal, Shatavisa Mukherjee, Ankit Shalikram Gedam, Rounak Das
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.47
Abstract
Background: The current management of primary open angle glaucoma involves cutting edge diagnostic technology but the clinical examination of the optic disc still remains the mainstay of both diagnosis and therapy. The disc damage likelihood scale is a useful tool devised to diagnose and follow up glaucoma patients.
Purpose: To compare the Disc Damage Likelihood Scale (DDLS) vis-à-vis the vertical cup disc ratio (VCDR) to document optic disc changes in primary open angle glaucoma (POAG) patients with respect to visual field changes and central corneal thickness (CCT).
Materials & Methods: 109 eyes of 57 patients attending the Glaucoma clinic at a tertiary care hospital, underwent clinical evaluation, complete medical and ophthalmic history profiling, slit lamp examination, applanation tonometry, Gonioscopy, 78 D biomicroscopy, specular microscopy for CCT and visual field analysis ( HFA 24-2 program). The patients’ VCDR, DDLS, MD, PSD and CCT were recorded and Pearson’s correlation coefficients were calculated for all data sets.
Results: 57 patients underwent this study with a mean age of 53.74 years. The Pearson’s correlation coefficient (r) for VCDR vs MD was 0.603 and that for DDLS vs MD was 0.821. The r for VCDR vs PSD was 0.447 and that for DDLS vs PSD was 0.621. The r for VCDR and DDLS Vs CCT was -0.57 and -0.61 respectively.
Conclusion: The DDLS is a better system than the VCDR as it correlates more strongly with visual field indices and CCT. It increases the clinical disc evaluation value for glaucoma patients at no extra cost.
Keywords-Disc damage likelihood scale, Vertical cup disc ratio, Automated perimetry, Central corneal thickness.
References
1. Armaly MF. Genetic Determination of Cup/Disc: Ratio of the Optic Nerve. Archives of Ophthalmology. 1967 Jul 1;78(1):35-43.
2. Armaly MF, Sayegh RE. The cup/disc ratio: the findings of tonometry and tonography in the normal eye. Archives of Ophthalmology. 1969 Aug 1;82(2):191-6.
3. Quigley HA. Early detection of glaucomatous damage: II. Changes in the appearance of the optic disk. Survey of ophthalmology. 1985 Oct 31;30(2):117-26.
4. Jonas JB, Schmidt AM, Müller-Bergh JA, Schlötzer-Schrehardt UM, Naumann GO. Human optic nerve fiber count and optic disc size. Investigative ophthalmology & visual science. 1992 May 1;33(6):2012-8.
5. Caprioli J. Discrimination between normal and glaucomatous eyes. Investigative ophthalmology & visual science. 1992 Jan 1;33(1):153-9.
6. Quigley HA, Coleman AL, Dorman-Pease ME. Larger optic nerve heads have more nerve fibers in normal monkey eyes. Archives of Ophthalmology. 1991 Oct 1;109(10):1441-3
7. Spaeth GL, Henderer J, Steinmann W. The disc damage likelihood scale: its use in the diagnosis and management of glaucoma. Highlights Ophthalmol. 2003 Apr;31(4):4-16.
8. Bayer A, Harasymowycz P, Henderer JD, Steinmann WG, Spaeth GL. Validity of a new disk grading scale for estimating glaucomatous damage: correlation with visual field damage. American journal of ophthalmology. 2002 Jun 30;133(6):758-63.
9. Henderer JD, Liu C, Kesen M, Altangerel U, Bayer A, Steinmann WC, Spaeth GL. Reliability of the disk damage likelihood scale. American journal of ophthalmology. 2003 Jan 31;135(1):44-8.
10. Ehlers N, Bramsen T, Sperling S. Applanation tonometry and central corneal thickness. Acta ophthalmologica. 1975 Mar 1;53(1):34-43.
11. Gordon MO, Beiser JA, Brandt JD, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK, Wilson MR, Kass MA. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Archives of ophthalmology. 2002 Jun 1;120(6):714-20.
12. Herndon LW, Weizer JS, Stinnett SS. Central corneal thickness as a risk factor for advanced glaucoma damage. Archives of Ophthalmology. 2004 Jan 1;122(1):17-21.
13. Spaeth GL, Henderer J, Liu C, Kesen M, Altangerel U, Bayer A, Katz LJ, Myers J, Rhee D, Steinmann W. The disc damage likelihood scale: reproducibility of a new method of estimating the amount of optic nerve damage caused by glaucoma. Transa-ctions of the American Ophthalmological Society. 2002;100:181.
14. Danesh-Meyer HV, Gaskin BJ, Jayusundera T, Donaldson M, Gamble GD. Comparison of disc damage likelihood scale, cup to disc ratio, and Heidelberg retina tomograph in the diagnosis of glaucoma. British journal of ophthalmology. 2006 Apr 1;90(4):437-41.
15. Chandra A, Bandyopadhyay AK, Bhaduri G. A comparative study of two methods of optic disc evaluation in patients of glaucoma. Oman journal of ophthalmology. 2013 May 1;6(2):103.
16. Papadia M, Sofianos C, Iester M, Bricola G, Mete M, Traverso CE. Corneal thickness and visual field damage in glaucoma patients. Eye. 2007 Jul 1;21(7):943-7.
17. Chauhan BC, Hutchison DM, LeBlanc RP, Artes PH, Nicolela MT. Central corneal thickness and progression of the visual field and optic disc in glaucoma. British journal of ophthalmology. 2005 Aug 1;89(8):1008-12.
18. Rogers DL, Cantor RN, Catoira Y, Cantor LB, WuDunn D. Central corneal thickness and visual field loss in fellow eyes of patients with open-angle glaucoma. American journal of ophthalmology. 2007 Jan 31;143(1):159-61.