OPHTHALMOSCOPIC EVALUATION OF THE OPTIC NERVE HEAD

Abstract

Background. Optic nerve diseases, such as glaucomas, lead to changes in the intrapapillary and parapapillary region of the optic nerve head.Conclusions. These changes can be described by the following variables: size and shape of the optic disc; size, shape, and pallor of the neuroretinal rim; size of the optic cup in relation to the area of the disc; configuration and depth of the optic cup; ratios of cup to disc diameter and cup to disc area; position of the exit of the central retinal vessel trunk on the lamina cribrosa surface; presence and location of splinter-shaped hemorrhages; occurence, size, configuration, and location of parapapillary chorioretinal atrophy; diffuse and/or focal decrease of the diameter of the retinal arterioles; and visibility of the retinal nerve fiber layer (RNFL). These variables can be assessed semiquantitively by ophthalmoscopy without applying sophisticated techniques. For the early detection of glaucomatous optic nerve damage in ocular hypertensive eyes before the development of visual field loss, the most important variables are neuroretinal rim shape, optic cup size in relation to optic disc size, diffusely or segmentally decreased visibility of the RNFL, occurence of localized RNFL defects, and presence of disc hemorrhages.

Keywords

• cup/disc ratio
• neuroretinal rim
• optic cup
• optic disc
• optic disc hemorrhages
• optic disc pallor
• parapapillary atrophy
• retinal nerve fiber layer
• retinal vessel diametre