Differentiation by imaging of superior segmental optic hypoplasia and normal-tension glaucoma with inferior visual field defects only

Abstract

Purpose: To differentiate superior segmental optic hypoplasia (SSOH) from normal-tension glaucoma (NTG) with inferior visual field defects only. Methods Eighteen eyes with SSOH (SSOH group) and 19 eyes with NTG (NTG group) were examined by optical coherence tomography (OCT), Heidelberg retina tomography (Heidelberg Retinal Tomograph II, HRT II) and standard automated perimetry.Results: Retinal nerve fiber layer thickness (RNFLT) based on OCT measurements was significantly reduced (thinner) in the superior to superonasal sectors and significantly greater (thicker) in the inferotemporal sector in the SSOH group than in the NTG group. The cup was significantly smaller and the rim significantly larger in the superotemporal and temporal sectors in the SSOH group than in the NTG group based on HRT II measurements. The greatest area under the receiver operating characteristic curve for discrimination of SSOH from NTG by OCT and HRT II was for the RNFLT ratio of 1 +2 o'clock/10 +11 o'clock (0.985) and for the ratio of the superonasal to superotemporal sector of rim to disc area ratio and cup to disc area ratio (0.955), respectively. The frequent location of the inferior visual field defects corresponded to the difference in structural changes in both groups.Conclusions: Comparison of the superonasal to superotemporal sectors by OCT and HRT II were useful in differentiating SSOH from NTG with only inferior visual field defects.

The Different Characteristics of Cirrus Optical Coherence Tomography between Superior Segmental Optic Hypoplasia and Normal Tension Glaucoma with Superior Retinal Nerve Fiber Defect

“…In our previous report, we also showed the same pattern using cirrus OCT and we showed the greatest AUROC to be the 1 o'clock segment in the superonasal portion of the pRNFL [ 6 ]. Yamada et al reported similar results, in that the RNFL of SSOH eyes were thinner in the superior to superonasal segment using Stratus OCT [ 14 ]. In the present study, SSOH eyes showed thinner pRNFL than normal controls except for the inferotemporal to temporal area compared to age-matching normal controls.…”

A case of topless disc syndrome (superior segmental optic hypoplasia)

“…A small cohort comparison of superior segmental optic hypoplasia (n = 18) and normal tension glaucoma (n = 19) eyes showed that superior segmental optic hypoplasia eyes exhibit a thinner supero‐nasal nerve fibre layer than normal tension glaucoma eyes . Comparing the ratio of supero‐temporal (10.00 to 11.00 hours) to supero‐nasal (01.00 to 02.00 hours) nerve fibre layer thickness may help differentiate normal tension glaucoma from superior segmental optic hypoplasia with similar visual field defects.…”

“…Comparing the ratio of supero‐temporal (10.00 to 11.00 hours) to supero‐nasal (01.00 to 02.00 hours) nerve fibre layer thickness may help differentiate normal tension glaucoma from superior segmental optic hypoplasia with similar visual field defects. A supero‐temporal:supero‐nasal ratio of 0.312 provides a sensitivity of 100 per cent and specificity of 94.4 per cent …”