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Reversal of optic disc cupping in glaucoma

Helsinki University Eye Hospital, Helsinki, Finland

Correspondence to:
Dr M Harju, Helsinki University Eye Hospital, Haartmaninkatu 4 C, PO Box 220, 00029 Hus, Finland; mika.harju{at}aad.fi

Aim: To study whether reversal of optic disc cupping after intraocular pressure (IOP) reduction is related to risk of glaucoma progression.

Methods: In this prospective follow-up study, where 51 patients with exfoliation glaucoma and five with ocular hypertension combined with exfoliation syndrome were followed for 6 years after IOP reduction, 24 showed progression of glaucoma in visual fields or optic nerve head (ONH) stereophotographs. ONH topography was measured with the Heidelberg Retina Tomograph (HRT). A decrease in HRT parameter cup volume of more than 5% was considered cup reversal. Multiple logistic regression was used to model progression of glaucoma.

Results: Cup reversal (OR 0.226; 95% CI 0.055 to 0.918, p = 0.037), final IOP (OR 1.216; 95% CI 1.000 to 1.479, p = 0.050) and visual field mean defect at entry (OR 1.158; 95% CI 1.034 to 1.296, p = 0.011) were associated with progression. IOP change from study entry to 6-year control visit was not associated with progression (OR 0.964, 95% CI 0.850 to 1.092, p = 0.56).

Conclusion: Cup reversal seemed to be an independent protective factor for progression of glaucoma.

Competing interests: None.

Ethics approval: The procedures followed the tenets of the Declaration of Helsinki and were approved by the Helsinki University Eye Hospital Ethics Committee.

Patient consent: Patient consent was obtained.