gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Macro disks: a challenge for automated, morphometric glaucoma diagnosis

Meeting Abstract

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  • corresponding author C. Mardin - Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen
  • F. Horn - Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen
  • A. Viestenz - Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.06.03

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Mardin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Very, large healthy optic disks are often characterised to be glaucomatous in automated, morphometric analysis. Aim of this study was to investigate the variables of Laser-Scanning-Tomography (LST) and nerve fibre polarimetry of these disks in comparison to small and normal sized disks.


200 eyes (age 51,0±14,3a) with healthy, non-atrophic disks (md= 0,8dB, IOP 14,4±2,6mmHg) of the Erlangen Glaucoma Registry were clinically examined. Morphometry was performed both by planimetry and the HRT I (Heidelberg Engineering, Dossenheim, version 2.01) and with the GDx (Laser Diagnostics, San Diego). All measurements were analysed globally and in four sectors according to Jonas and subdivided into four classes according to the global disk area: I 1,0-2,0mm2 (micro discs), II 2,01-2,5mm2, III 2,51-3,5mm2 und IV 3,51-6,0mm2 (macro discs).


Both the multivariate analysis of the HRT and the GDx revealed a significant correlation with total disk area (R=0,34, p=0,0001), with an increasing percentage of false positive glaucoma eyes among class IV disks. Cup area and volume showed in contrast to rim volume and rim area a significant correlation (R=0,76, p=0,0001) with the disk size. Thickness of retinal nerve fibre layer measurements both in HRT and GDx showed decreasing values with growing disk size and an increasingly steeper cup. The vertical diameter of the cup increased in comparison to the horizontal to higher extent with growing disc size.


By the pronounced enlargement of cup measurements, decreasing nerve fibre thickness values and decreasing ratio of temporal-to-inferior width of the neuroretinal rim macro disks may easily be detected as false glaucomatous by morphometric analysis systems. A higher proportion of macro disks in a normative database and integration of sectors and disk area in a multivariate analysis may improve the diagnostic abilities of automated morphometric disk analysis.