Propose: Cupping of the optic nerve head is a classic sign of glaucoma, however non-glaucomatous optic neuropathies can cause changes of the optic nerve head as well). Currently, information from perimetry, optic nerve head pallor and visual acuity are used to aid in differentiating glaucomatous from non-glaucomatous optic nerve cupping. Optical coherence tomography (OCT) has been shown to have good reproducibility of RNFL thickness measures and monitoring glaucomatous disease progression.
Patients and Methods: This study included a total of 50 eyes with optic cupping; 32 eyes with glaucoma, 8 eyes with neurological disorders, 8 eye with physiological cupping and only two eyes glaucoma suspects. All patients were subjected to ophthalmic examinations and investigations to assess causes of optic disc cupping.
Results: There was no significant difference between studied groups regarding cup to disc ratio. There was statistically significant difference between studied groups regarding ISNT rule, only 28.1% of eyes in glaucoma group followed the rule, compared with 50.0% in neurological disorders. All eyes with physiologic cupping or who were glaucoma suspect followed that rule. No visual field defects were detected in physiological cupping and glaucoma suspect eyes, although glaucomatous eyes showed visual field defects respecting the horizontal meridian in most of the studied eyes, while neurological disorders eyes respected the vertical meridian.
Conclusion: Visual field and OCT appeared to be a useful technology in evaluation non-glaucomatous optic disc cupping, as the pattern of RNFL loss was varied depending upon the etiology.