Makropapillen mit physiologischer Makroexkavation (Pseudo-Glaukompapillen) - Papillometrische Charakteristika in 17 Augen

Characteristics of 17 optic disks larger than 4.4 mm2 and thus satisfying the papillometric criteria of macrodisks (larger than normal optic disks plus two-fold standard deviation) were as follows: (1) Form: similar to normal optic nerve heads but even more circular. The vertical diameter was about 6% larger than the horizontal. (2) Optic cup: abnormally large, therefore "pseudoglaucomatous." (3) Neuroretinal rim: normal-sized when correlated to the total optic disk area, larger in the temporal lower than in the temporal upper optic disk region, narrowest on the temporal optic disk side, larger nasally at the top, and widest at the upper optic disk pole. (4) Cup/disk ratio: abnormally high (0.76 +/- 0.06 horizontally, 0.69 +/- 0.05 vertically), larger horizontally than vertically. (5) Perimetry: the only abnormality was an increased blind spot corresponding to the enlarged optic disk area. (6) Refraction. -0.25 +/- 1.90 diopters (high myopics less than -8.00 diopters) had been excluded). (7) Central retinal artery and vein penetrating the superficial lamina cribrosa almost at the center of the cup, bayonetlike vessel bending at the border of the optic cup. (8) Increased number of cilioretinal arteries, corresponding to their correlation with the optic disk area. These macrodisks with physiologic macrocups can be differentiated by their morphology or by optic disk planimetry in absolute values from: normal-sized optic nerve heads with glaucomatous cupping, abnormally large optic nerve heads in highly myopic eyes, and abnormally large optic nerve heads with pitting of the optic disk.