In-Vivo Microstructural Anatomy of β-Zone Parapapillary Atrophy in Glaucoma

Park, Sung Chul; Moraes, Carlos Gustavo V. De; Tello, Celso; Liebmann, Jeffrey M.; Ritch, Robert

doi:10.1167/iovs.09-5100

Cited by 27 publications

(23 citation statements)

References 34 publications

(37 reference statements)

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“…Our histological results on a parapapillary region (''gamma'' zone) between the border of the optic nerve (as defined by the outer surface of the pia mater) and the beginning of Bruch's membrane confirms previous clinical studies and histologic single case descriptions [7][8][9][10][11][12][13][14][15]. Using spectral-domain optical coherence tomography, Hayashi and colleagues examined the peripapillary atrophy in 100 patients with primary open-angle glaucoma and in 100 normal subjects [13].…”

Section: Discussionsupporting

confidence: 82%

“…This finding was corroborated by clinical studies [6]. For medium myopic eyes, recent clinical investigations using optical coherence tomography have shown another feature: between a beta zone (characterized by Bruch's membrane) and the border of the optic disc, the images demonstrated a zone which was composed simply of sclera and overlying retinal nerve fiber layer tissue [7][8][9][10][11][12][13][14]. We therefore, reassessed histological slides of human globes without and with axial elongation and without and with glaucoma.…”

Section: Introductionsupporting

confidence: 70%

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Parapapillary atrophy: histological gamma zone and delta zone

Jonas¹,

Jonas²,

Jonas³

et al. 2012

Acta Ophthalmologica

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Section: Discussionsupporting

confidence: 82%

Section: Introductionsupporting

confidence: 70%

Parapapillary atrophy: histological gamma zone and delta zone

Jonas¹,

Jonas²,

Jonas³

et al. 2012

Acta Ophthalmologica

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“…[1][2][3] The sclera in the gamma zone is directly covered by the elongated and thinned peripapillary choroidal border tissue of Jacoby and the retinal nerve fibers. [4][5][6][7][8][9][10] It has been shown that larger parapapillary gamma zone size is strongly associated with longer ocular axial length, but the etiology of the gamma zone has remained elusive so far.…”

mentioning

confidence: 99%

Parapapillary Gamma Zone and Progression of Myopia in School Children: The Beijing Children Eye Study

Yin

Liu

Tang

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To assess the development and enlargement of the parapapillary gamma zone in school children.METHODS. This school-based prospective longitudinal study included Chinese children attending grade 1 in 2011 and returning for yearly follow-up examinations until 2016. These examinations consisted of a comprehensive ocular examination with biometry and color fundus photographs. The parents underwent a standardized interview. The parapapillary gamma zone was defined as the area with visible sclera at the temporal optic disc margin, and the optic disc itself was measured on fundus photographs. RESULTS.The study included 294 children (mean age in 2016, 11.4 6 0.5 years [range, 10-13 years]; mean axial length, 24.1 6 1.1 mm [range, 21.13-27.29 mm]). In multivariate analysis, larger increases in the gamma zone area during the study period were correlated (coefficient of determination for bivariate analysis [r 2 ], r 2 ¼ 0.69) with larger increases in the vertical-to-horizontal disc diameter ratios (P < 0.001; standardized regression coefficient beta [beta], 0.53; nonstandardized regression coefficient B [B], 4.05; 95% confidence intervals [CI], 3.37-4.73), larger axial elongation (P < 0.001; beta, 0.32; B, 0.37; 95% CI, 0.26-0.47), a larger vertical disc diameter at baseline (P < 0.001; beta, 0.22; B, 0.98; 95% CI, 0.62-1.33), a larger gamma zone area at baseline (P < 0.001; beta, 0.14; B, 0.41; 95% CI, 0.17-0.64), and more time spent indoors studying (P ¼ 0.015; beta, 0.10; B, 0.09; 95% CI, 0.02-0.17).CONCLUSIONS. The development and enlargement of the gamma zone in the temporal parapapillary region were associated with an optic disc rotation around the vertical disc axis as indicated by an increasing vertical-to-horizontal disc diameter ratio. These morphologic findings fit with the notion of a backward pull of the temporal peripapillary sclera through the optic nerve dura mater in axially elongated eyes.

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“…Beta-zone PPA occurs adjacent to the optic disc and is notable for atrophy of the retinal pigment epithelium, photoreceptors, and choriocapillaris and visible large chroidal vessels and occurs in two-thirds of glaucoma patients and 20% of normal individuals . Spectraldomain OCT can be used to precisely define the region without intact retinal pigment epithelium (Park et al, 2010).…”

Section: Beta-zone Ppamentioning

confidence: 99%