Free previewYou're reading the free part of this topic. The rest is included with Clinical.See what's included
Preperimetric Glaucoma
Glaucoma
Key Points
- •Preperimetric glaucoma = structural damage (OCT abnormal, disc changes) with normal standard automated perimetry - it represents the structure-function gap where 25–35% of RGCs may be lost before VF defects appear
- •OCT RNFL and GCC/GCA analysis are the primary detection tools - look for sectors in the red zone (<1st percentile), hemifield asymmetry in GCC, and rate of thinning >1 micrometre/year (suspicious) to >2 micrometres/year (clearly pathological) (vs normal ~0.5/year)
- •Disc haemorrhage is the strongest clinical predictor of progression from preperimetric to manifest glaucoma - its presence should lower the treatment threshold
- •10-2 perimetry may detect early paracentral defects missed by 24-2 - order 10-2 when OCT shows macular GCC thinning in a preperimetric patient
- •Treatment decision is risk-stratified: treat high-risk patients (disc haemorrhage, high IOP, thin CCT, rapid progression) with prostaglandin analogues or SLT; observe lower-risk patients with serial OCT every 6 months
Free preview ends here
Keep reading Preperimetric Glaucoma
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations