272 Med Arh. 2013 Aug; 67(4): 272-274 • ORIGINAL PAPER Infuence of the Optic Disc Size on Cup Diameter in Patients with Glaucoma Simplex Chronicum DOI: 10.5455/medarh.2013.67.272-274 Med Arh. 2013 Aug; 67(4): 272-274 Received: April 28th 2013 | Accepted: July 15th 2013 CONFLICT OF INTEREST: NONE DECLARED ORIGINAL PAPER Influence of the Optic Disc Size on Cup Diameter in Patients with Glaucoma Simplex Chronicum Edita Dervisevic 1 , Emina Alimanovic Halilovic 1 ,Tarik Masic 2 , Almir Dervisevic 2 Eye clinic, Clinical center of University of Sarajevo, Sarajevo, Bosnia and Herzegovina 1 Clinic for maxillofacial surgery, Clinical center of University of Sarajevo, Sarajevo, Bosnia and Herzegovina 2 I ntroduction: Te relationship between the optic disc size, neuroretinal rim and cup diameter is the key in identifying glaucomatous changes in optic nerve head. Like some other biologi- cal characteristics, changes of the optic disc difer among healthy populations, thus hindering detection of pathological changes. Materia and methods: From the total number of 90 patients, we selected those that have optic disc diameter less than 1.30 mm, greater than 2.10 mm, as well as patients with a size of disc diameter ranging from 1.31mm to 2.09 mm. In all patients after an- amnesis and standard ophthalmologic examination (best corrected visual acuity-BCVA, Goldman aplanatic tonometry, pachymetry, gonioscopy), we also performed the OCT analysis of the optic nerve head. Results and discussion: Glaucomatous changes in small optic discs may remain unnoticed unless there is a high degree of suspicion. Te assesment of the optic disc size is an important, but often overlooked component of the diagnostic evaluation in glaucoma. Tere was a statistically signifcant strong positive correlation between the size of the optic disc diameter and cup diameter, larger optic disc diameter means greater cup diameter. Due to the large variation in the cup size in healthy subjects, the assessment of the morphology of the neuroretinal rim or cup diameter can be more helpful in evaluation of glaucomatous optic disc damage than the value of C/D ratio itself. Conclusion: Evaluation of the optic disc size and C/D ratio is an essential part in diagnostic procedure and management of glaucoma. OCT analysis in patients with small optic disc diameter showed the least sensitivity in all three categories (normal, abnormal and uncer- tain OCT results). Te OCT results in the small optic disc diameter are the least reliable in the diagnosis of glaucoma. More complexed long term study is needed to evaluate this complicated relations between optic disc diameter, C/D ratio, neuroretinal rim and other important clinical factors in emerging glaucoma disease. Key words: optic disc, cup/disc ratio, glaucoma simplex chronicum, OCT Corresponding author: Edita Dervisevic, MDD. E-mail: emaedita@gmail.com 1. INTRODUCTION Glaucoma represents a group of eye diseases in which there is damage to the optic nerve and can, if left untreated, re- sult in a complete loss of vision. Glauco- matous disease is one of the most com- mon causes of blindness in developed countries. To understand and assess the presence of glaucomatous changed optic nerve, it is necessary to know the characteristics of healthy optic discs. Tere is a signifcant diference in the size of the optic disc among healthy populations. Te size can vary from 0.80 mm2 to about 6.00 mm2 in the normal population (2) Values have a Gaussian distribution with signifcance (± SD) of 2.69 ± 0.70mm2) Tese fgures relate to healthy Caucasian and may vary in relation to other populations. Much more important than the op- tic disc classifcation according to its size, is how the size of the disc afects cup diameter and neuroretinal rim area. Determining the size of the cup and its relation to the size of the disc, ie C / D ratio, is widely used to distinguish glaucomatous and healthy eyes. Verti- cal cup expansion is typical character- istic of glaucomatous optic neuropathy. Size of cup in the normal population is largely dependent on the physiological relationship of the cup ratio and the size of the optic nerve head. (1,7) With the increase ofdisc size grows as well and C/D ratio, so large optic disc in healthy people have large C/D ratio which may lead to wrong diagnosis of glaucoma. Similarly small cup in small optic disc can be glaucomatous. Involv- ing the optic disc size in estimation of the E/D ratio proves the correctness of the measurements in the detection of glaucoma (7). Moreover, examination of other disc characteristics will help us in establishing diagnosis. 2. MATERIALS AND METHODS In order to make scientifcally valu- able statistical comparisons we tested approximately 60 eyes in each group, a total of 180 eyes. From the total num- ber of 90 patients, we selected those that have optic disc diameter less than 1.30 mm, greater than 2.10 mm, as well as patients with a size of disc diameter ranging from 1.31mm to 2.09 mm. In order to make scientifcally valuable sta- tistical comparisons we tested approxi-