Atlas of Ophthalmology

Pseudoglaucomatous Macrodisks with Physiologic Macrocups in Daughter (Mosaic, Colour Photography Posterior Pole, HRT, SD-OCT)

Pseudoglaucomatous Macrodisks with Physiologic Macrocups in Daughter (Mosaic, Colour Photography Posterior Pole, HRT, SD-OCT)
Mosaic, daughter: Colour Photography Posterior Pole: abnormally high cup/disk ratios; HRT: optic cup size 3,25 mm² at OD, 3,14 mm² at OS; SD-OCT: no focal or diffuse thinning of retinal nerve fiber layer at OD and OS. Patient: mother 53 years of age, female, BCVA 1.0 at OD, 1.0 at OS, IOP 18/ 19 mmHg; daughter 15 years of age, female, BCVA 1.0 at OD, 1.0 at OS, IOP 16/ 14 mm General Medical History: no events reported. Ocular medical History: questable glaucoma in mother and daughter. Purpose: to present pseudo-glaucoma disks in mother and daughter. Methods: Colour Photography Posterior Pole, SD-OCT, HRT, Visual Fields. Findings: Mosaic, mother: Colour Photography Posterior Pole: abnormally high cup/disk ratios; HRT: optic cup size 3,5 mm² at OD, and 3,9mm² at OS; SD-OCT: no focal or diffuse thinning of retinal nerve fiber layer at OD and OS. Mosaic, daughter: Colour Photography Posterior Pole: abnormally high cup/disk ratios; HRT: optic cup size 3,25 mm² at OD, 3,14 mm² at OS; SD-OCT: no focal or diffuse thinning of retinal nerve fiber layer at OD and OS. Colour Photography Posterior Pole, mother: normal optic nerve head form, vertical diameters larger than the horizontal, abnormally large optic cups, abnormally high cup/disk ratios. Colour Photography Posterior Pole, daughter: normal optic nerve head form, vertical diameters larger than the horizontal, abnormally large optic cups, abnormally high cup/disk ratios HRT, daughter: optic cup size 3,5 mm² at OD, and 3,9mm² at OS. HRT, mother: optic cup size 3,25 mm² at OD, 3,14 mm² at OS. SD-OCT, mother: no focal or diffuse thinning of retinal nerve fiber layer at OD and OS. SD-OCT, daughter: no focal or diffuse thinning of retinal nerve fiber layer at OD and OS. Visual Fields, mother: regular visual field at OD and OS, no focal or diffuse scotomas. Visual Fields, daughter: regular visual field at OD and OS, no focal or diffuse scotomas Discussion: Jonas et al. (1) described macrodisks as similar to normal optic nerve head form but even more circular, vertical diameters larger than the horizontal, abnormally large optic cups, and abnormally high cup/disk ratios. Klein et al. (2) examined the stereoscopic pairs of photographs of optic disc, both vertical and horizontal disc and cup diameters and found a consistent and strong quantitative relationship of vertical optic cup dimensions in parents and children. He found that heritability estimates were 0.55, and 0.57 for intraocular optic cup diameter, and optic disc diameter, respectively. Literature: (1) Jonas JB, Gusek G, Naumann GO. Macrodisks with physiologic macrocups (pseudo-glaucoma disks). Papillometric characteristics in 17 eyes. Klin Monbl Augenheilkd. 1987 Dec;191(6):452-7. (2) Klein BE, Klein R, Lee KE. Heritability of risk factors for primary open-angle glaucoma: the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 2004 Jan;45(1):59-62.
Michelson, Georg, Prof. Dr. med., Interdisziplinäres Zentrum für augenheilkundliche Präventivmedizin und Imaging, Augenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Erlangen, Deutschland
H40.0
Optic Nerve -> Normal Variants -> Pseudoglaucomatous Macrodisks with Physiologic Macrocups in Mother and Daughter (Colour Photography Posterior Segment, HRT, VF, SD-OCT)
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