Fizyolojik optik sinir başı çukurlaşması olan olgularda optik sinir başının heidelberg retina tomografisi ve optik koherens tomografi ile değerlendirilmesi: karşılaştırmalı çalışma

amaclandi. Gerec ve Yontem: Daha once glokom tanisi almamis ve rutin muayenede cup/disk orani (C/D) ≥ 0.6 olan fizyolojik cukurlasmali 57 olgunun 57 gozu ile C/D ≤ 0.4 olan 55 olgunun 55 gozu (normal grup) ve glokom birimimizde takipli erken glokomatoz hasari olan 56 hastanin 56 gozu calismaya alindi. Tum olgulara tam oftalmolojik muayene, gun ici intraokuler basinc takibi, gonyoskopi, santral kornea kalinligi (SKK), OKT ile RSLT kalinlik analizleri, HRT ile OSB parametreleri olcumleri ve GA testleri yapildi. Tum olgularin birer gozleri randomize olarak secildi. Bulgular: OKT ve HRT ile yapilan olcumlerde uc grup arasinda anlami farklilik oldugu goruldu (p<0.001). FC'li olgularin disk alaninin her iki gruptan anlamli olarak daha buyuk oldugu goruldu (p<0.001). FC'li olgularin cukurluk alani EG'lu olgularin cukurluk alanina benzer (p=0.085) bulunurken NK grubundaki olgulardan anlamli olarak yuksek bulunmustur (p<0.001). Rim alaninda beklendigi gibi FC'li ve NK' lu olgular arasinda fark yoktu (p=0.355) ve her iki grubun rim alani EG'lu olgulardan daha kalin olarak olculdu (p=0.002). FC, EG olgulari birbirinden ayirdedebilen en onemli OKT parametresinin ortalama RSLT kalinligi oldugu goruldu. OKT ve HRT ile yapilan olcumlerin FC'li olgulari ayirt etmedeki duyarliligi ve ozgunlugu karsilastirildiginda OKT'nin daha ustun oldugu goruldu. Sonuc: Optik koherens tomografi ve Heidelberg retina tomografisi genis optik sinir basi cukurlugu olan olgularin glokomdan ayriminda faydali olabilirler. Anahtar kelimeler: Fizyolojik cukurlasma, OKT, HRT, RSLT ABSTRACT Optic nerve head evaluation with heidelberg retinal tomography and optical coherence tomography in cases with physiologic large cups: a comperative study Objective: In this study we evaluated the optic nerve head (ONH) cupping parameters and thickness of retinal nerve fibre layers (RNFL) with Heidelberg retinal tomography (HRT) and optical coherence tomography (OCT) in patients with the diagnosis of physiological cupping whose intraocular pressure (IOP) and visual fields (VF) are normal but ONH cupping is more than 0.6. We then compared them with early glaucomatous (EG) patients and normal cases as control (NK). Material and Methods: The study enclosed 57 eyes of 57 patients having no previous diagnosis of glaucoma but with physiological cupping C/D≥0.6 on routine ophthalomological evaluation and 56 eyes of 56 early glaucomatous patients followed in our glaucoma unit. Control group (NK) consisted of 55 eyes of 55 cases with C/D≤0.4. All the patients were evaluated with whole ophthalmologic examination, intraocular pressure measurements, with gonioscopy and tests for thickness of central cornea (TCC), OCT, RNFL analyses, HRT, ONH parameters and VF tests. Only one eyes of each patient were randomly chosen. Results: All of the three groups were comparable with regards to TCC and refraction values (p=0.437 and p=0.478). But there was significant differences regarding OCT and HRT evaluations (p<0.001). Disc areas of PC cases were greater than those of other groups (p<0.001). The cupping area of PC cases was similar to those of EG cases (p=0.085) whereas it was significantly greater than those in control group (p<0.001). There was no difference in Rim area of PC and C groups as was expected (p=0.355) and Rim area of both groups was measured thicker than that of EG cases (p=0.002). It was seen that the most important OCT parameter differentiating PC and EG cases from each other was mean RNFL thickness. When the sensitivity and specificity of OCT and HRT measurements in differentiating PC cases were compared it was seen that OCT was superior. Conclusion: Optic coherence tomography and Heidelberg retinal tomography might be valuable in differentiating between large optic nerve head