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April 1996

Neural Rim Area Declines With Increased Intraocular Pressure in Urban Americans

Author Affiliations

Detroit, Mich

Arch Ophthalmol. 1996;114(4):500. doi:10.1001/archopht.1996.01100130496034

I read with interest the article by Varma et al1 in the August 1995 issue of the Archives. They made an important observation of intraocular pressure (IOP)—related decline in the neural rim area among urban Americans who did not have known optic nerve damage. They believe that the IOP-related decline in neural rim area probably represents loss of neural tissue in the optic nerve, rather than IOP-related posterior deformation of the optic disc tissue or loss of astroglial tissue in the optic nerve. I have no problem with the authors' contention regarding lack of involvement of the astroglial tissue loss. However, I do not believe that the apparent decline in neural rim area is entirely due to loss of neural tissue in the optic nerve. Our experience regarding IOP-dependent dynamic changes in optic disc cupping in patients with primary, open-angle glaucoma suggests otherwise.2 Therefore, the IOP-related decline in

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