Purpose To examine the morphologic features of clinical beta-zone parapapillary atrophy by using enhanced depth imaging optical coherence tomography (EDI-OCT) and color fundus photographs.
Methods Color fundus photographs and horizontal cross-sectional B-scan images of EDI-OCT were obtained in 61 eyes of normal subjects and 61 eyes of primary open-angle glaucoma (POAG) patients with beta-zone parapapillary atrophy. We measured beta-1 zone and beta-2 zone. Beta1-zone was defined as the region between the temporal disc margin to the beginning of Bruch´s membrane. Beta2-zone was defined as the region between the beginning of Bruch´s membrane to the outer border of beta zone.
Results Beta1-zone (mean length: 0.49 ± 0.44 mm, median: 0.32mm; range: 0 to 2.25 mm)) increased significantly (P<0.001) with myopic refractive error and axial length (r2=0.81 and 0.74, respectively). In the mild to moderate myopic group (-1.0D<refractive error<=-6.0D), the glaucomatous group (0.23 ± 0.23mm) and the non-glaucomatous group (0.31 ± 0.13mm) did not vary significantly (P=0.08) in size of beta1-zone. Similarly in the highly myopic group (refractive error>-6.0D), the glaucomatous group (0.58 ± 0.45mm) and the non-glaucomatous group (0.89 ± 0.64mm) did not vary significantly (P=0.08) in size of beta1-zone. Beta2-zone (mean length: 0.24 ± 0.17mm (median: 0.22; range: 0 to 1.09 mm)) was significantly (P=0.001) associated with glaucoma, but not significantly associated with refractive error (P=0.13) and axial length (P=0.38). Nine eyes showed a clear demarcation between beta1 and beta2 zone on the color fundus photographs.
Conclusion Conventional beta-zone of parapapillary atrophy can be sub-differentiated into beta1-zone (region without Bruch´s membrane), which was associated with myopia and was independent of glaucoma, and into beta2-zone (Bruch´s membrane without retinal pigment epithelium) which was significantly correlated with glaucoma but not with myopia. |
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