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Invest Ophthalmol Vis Sci. 2013 Mar 19;54(3):2013-8. doi: 10.1167/iovs.12-11255.

Microstructure of parapapillary atrophy: beta zone and gamma zone.

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Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.



To examine the morphologic features of parapapillary atrophy by using enhanced depth imaging optical coherence tomography (EDI-OCT) and color fundus photographs.


The clinical observational comparative study included 80 normal eyes of 46 subjects and 80 eyes of 46 patients with primary open-angle glaucoma. Both groups did not vary significantly in axial length (P = 0.62) and refractive error (P = 0.30). Color fundus photographs and cross-sectional B-scan images obtained by EDI-OCT were examined. On the EDI-OCT images, we measured a gamma zone defined as the region between the temporal disc margin to the beginning of Bruch's membrane, and a beta zone defined as Bruch's membrane without retinal pigment epithelium.


The gamma zone (mean area: 1.13 ± 2.04 mm(2)) was significantly associated with longer axial length (P < 0.001; standardized coefficient beta: 0.48), longer vertical disc diameter (P < 0.001; beta: 0.43), older age (P = 0.008; beta: 0.22), and the absence of glaucoma (P = 0.03; beta: -0.19). The beta zone (mean area: 0.85 ± 0.60 mm(2)) was associated with longer axial length (P < 0.001; beta: 0.39) and the presence of glaucoma (P < 0.001; beta: 0.48).


In addition to associations with older age, increasing myopia, and larger disc size, the EDI-OCT-defined gamma zone of parapapillary atrophy was associated with the absence of glaucoma, whereas the EDI-OCT-defined beta zone was associated with the presence of glaucoma. Differentiation between the beta zone and the gamma zone may be clinically useful.

[Indexed for MEDLINE]

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