Rahim, Adlina Abdul
(2012)
An assessment of optic nerve parameters in
Malay normal tension glaucoma and
Primary open angle glaucoma patients.
Masters thesis, Universiti Sains Malaysia.
Abstract
The recent availability of retinal imaging device plays an important role to
differentiate the appearance of optic nerve in normal tension glaucoma (NTG) and primary
open angle glaucoma (POAG) patients. There no published literature of these two group of
glaucoma in patients of Malay ethnicity, or even those who are living in South East Asian
areas. To compare optic nerve head parameters among Malay NTG and POAG patients using HR.T III analysis. A comparative cross sectional study was carried out from November 2010
till February 2012 in two hospitals with availability of glaucoma service. A total of 154
eyes of 154 Malay patients were included in this study; 32 NTG patients, 45 POAG patients and 77 control group. All participants underwent a thorough ocular examination including visual acuity, subjective refraction, anterior segment and fundus examinations,
Humphrey visual field 24-2, intraocular pressure measurement, gonioscopy examination and fundus photography. An assessment of optic nerve head parameters was conducted using FIRT III by an identified masked investigator in each hospital. Comparison of these
two glaucoma groups was further analyzed according to the appearance on cup disc ratio on
clinical assessment and AGIS scoring system. Both glaucoma groups had notably larger discs, larger cupping, smaller retinal
rims area and thinner nerve fiber layers when compared to the control group (p<0.05). NTG
patients revealed larger disc and cup areas when compared to the POAG patients (the mean (SD) for disc area was 2.65 (0.41) mm2 NTG group, and 2.40 (0.36) mm2 in POAG
group, p = 0.006; the mean cup area (SD) of NTG patients was 1.54 (0.43) mm2 and 1.32
(0.40) mm2 in POAG group, p = 0.027). This observation was also parallel when they were
further analyzed according to the severity of glaucoma in both studied groups. The optic nerve head parameters are significantly different in Malay NTG and
POAG patients when compared to healthy individuals. Disc and cup areas are significantly
larger in Malay NTG compared to POAG patients, while the other parameters are
comparable in both groups.
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