[Acute pressure-dependent change in the neuroretinal rim in juvenile glaucomatous papilla. Measurement with laser scanning tomography and planimetric biomorphometry].

BACKGROUND

In glaucomatous optic disc morphology follow-up, changes due to loss of nerve fibres should be distinguished from changes without loss of nerve fibres.

PATIENT AND METHOD: The intraocular pressure-dependent neuroretinal rim change in a 25-year-old white woman's optic nerve head, suffering from unilateral congenital glaucoma, had been documented papillometrically and by means of Laser Scanning Tomography. For papillometry, the optic disc outlines obtained from 15-degree stereo slides were evaluated planimetrically. To compute the volume of the optic disc excavation, 32 axially staggered optical sections were registered with a laser scanning retina tomograph (Heidelberg Engineering, Heidelberg) and computed three-dimensionally.

RESULTS

At an intraocular pressure level of 9 mm Hg a diminution of the planimetrical cup to disc ratio of about 20% and a reduction of the tomographically obtained excavation volume of about 55% was seen in comparison to 44 mm Hg one day before.--After 6-month follow-up, these parameters returned to their initial readings.

CONCLUSION

This phenomenon was attributed to an acute post-barotraumatic tissue edema.--To our mind, this single observation illustrates an acute change in optic disc morphology documented and quantified by laser scanning tomography.