[Skip to Content]
[Skip to Content Landing]
June 1980

Nonglaucomatous Excavation of the Optic Disc

Author Affiliations

From the Department of Ophthalmology, College of Medicine, University of Florida, Gainesville (Dr Trobe); Bascom Palmer Eye Institute (Drs Glaser, Herschler, and Anderson) and the Department of Biostatistics, University of Miami (Ms Cassady).

Arch Ophthalmol. 1980;98(6):1046-1050. doi:10.1001/archopht.1980.01020031036004

• In order to test the hypothesis that glaucomatous and nonglaucomatous optic disc cupping can be distinguished ophthalmoscopically, three ophthalmologists experienced in assessing optic dics were asked to view fundus stereophotographs as "unknowns." Of 29 eyes with nonglaucomatous optic atrophy, 13 (44%) were misdiagnosed as showing glaucoma by at least one observer. Of four optic disc features specifically analyzed, neuroretinal rim pallor proved to be 94% specific for nonglaucomatous atrophy, while focal or diffuse obliteration of the neuroretinal rim was 87% specific for glaucoma. These two signs are the most useful in making the distinction. Thinning of the rim was more common in glaucoma than in nonglaucomatous atrophy, but was only 47% specific for glaucoma. Laminar dots were present in both types of excavation.

Dalsgaard-Nielsen E:  Glaucoma-like cupping of the optic disc and its etiology . Acta Ophthalmol 15:151-178, 1937.Article
Blazar HA, Scheie HG:  Pseudoglaucoma . Arch Ophthalmol 44:499-513, 1950.Article
Miller S:  The enigma of glaucoma simplex . Trans Ophthalmol Soc UK 92:563-584, 1972.
Hayreh SS:  Pathogenesis of cupping of the optic disc . Br J Ophthalmol 58:863-876, 1974.Article
Eagling EM, Saunders MD, Miller SJH:  Ischemic papillopathy: Clinical and fluorescein angiographic review of 40 cases . Br J Ophthalmol 58:990-1008, 1974.Article
Quigley H, Anderson DR:  Cupping of the optic disc in ischemic optic neuropathy . Trans Am Acad Ophthalmol Otolaryngol 83:755-762, 1977.
Radius RL, Maumenee AE:  Optic atrophy and glaucomatous cupping . Am J Ophthalmol 85:145-153, 1978.
Schwartz B:  Cupping and pallor of the optic disc . Arch Ophthalmol 89:272-277, 1973.Article
Kirsch RE, Anderson DR:  Clinical recognition of glaucomatous cupping . Am J Ophthalmol 75:442, 1973.
Podos SM, Becker B:  Vertical elongation of the optic cup in glaucoma . Trans Am Acad Ophthalmol Otolaryngol 77:157, 1973.
Hitchings RA, Spaeth GL:  The optic disc in glaucoma: I. Classification . Br J Ophthalmol 60:778, 1976.Article
Von Graefe A:  Ueber die iridectomie bei Glaucom und uber den glaucomatosen Prozess . Von Graefe's Arch Klin Ophthalmol 4:456, 1857.Article
Kolker AE, Hetherington J (eds): Becker and Shaffer's Diagnosis and Therapy of the Glaucomas . St Louis, CV Mosby Co, 1970, pp 141-145.
Drance SM:  Some factors in the production of low-tension glaucoma . Br J Ophthalmol 56:229-236, 1972.Article
Chumbley LC, Brubaker RF:  Low-tension glaucoma . Am J Ophthalmol 81:761-767, 1976.
Lichter PR, Henderson JW:  Optic nerve infarction . Am J Ophthalmol 85:302-310, 1978.
Douglas GR, Drance SM, Schulzer M:  The visual field and nerve head in angle-closure glaucoma . Arch Ophthalmol 93:409-411, 1975.Article