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KMID : 1813520170060020031
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Journal of the Korean Glaucoma Society
2017 Volume.6 No. 2 p.31 ~ p.38
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The Change of Cup-to-Disc Ratio during Childhood Myopic Shift
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Park Yi-Ryeung
Hae-Young Lopilly Park
Park Chan-Kee
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Abstract
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Purpose : During eyeball growth in children, a progressive disc tilting and the elongation of the eyeball is observed. However, the glaucomatous eyes in childhood are still evaluated mainly with cup-to-disc ratio (CDR). On the basis of this background, the authors aimed to study the impact of elongation of eyeball and progressive disc tilting to CDR in eyes with childhood myopia.
Methods : Total of 68 eyes from 34 subjects younger than 14 years of age were included in the study. Serial disc photographs were reviewed retrospectively. The changes in the ratios of vertical disc diameter, cup-to-disc area, tilt ratio, torsion degree, disc to foveal angle, and peripapillary atrophy (PPA) and the relationships between the degree of axial elongation or the CDR were analyzed. Patients were divided into two groups according to the change of the CDR. When CDR decreased at last follow-up compared to the baseline, they were classified as ‘decreased CDR group’.
Results : The only value significantly different between the increased and decreased CDR groups was the change of tilt ratio (p = 0.009). Furthermore, in univariate and multivariate regression analysis, the change of CDR was negatively associated with changes of tilt ratio (p = 0.019, r = ?0.284), but the other factors as spherical equivalent (SE), SE change, baseline disc area, torsion degree, disc-foveal angle change, and PPA change were not significantly associated with the change of tilt ratio.
Conclusions : During axial elongation occur in children, in the cases that the tilting is the main change of the optic disc, the CDR may be underestimated, and therefore the physicians should bear in mind that glaucomatous change can be underestimated as well.
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KEYWORD
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Optic disc, Glaucoma, Myopia
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