Which finding at the optic nerve head is classically associated with glaucoma?

Which finding at the optic nerve head is classically associated with glaucoma?

• A. Cupping of the optic disc with thinning of the neuroretinal rim and possible pallor
• B. Optic disc swelling with hemorrhages
• C. No structural change
• D. Increased rim thickness

Answer: (A)

Glaucoma characteristically causes excavation of the optic nerve head, or cupping, driven by loss of retinal ganglion cell axons and remodeling at the lamina cribrosa. As these nerve fibers deteriorate, the neuroretinal rim thins and the cup enlarges relative to the disc, often most evident in the inferior and superior regions. With progression, pallor of the remaining neuroretinal tissue can appear as the rim becomes thinner. This combination—cupping with thinning of the neuroretinal rim (and possible pallor)—is the classic optic nerve head change in glaucoma. In contrast, disc swelling with hemorrhages points to optic neuritis or papilledema, no structural change isn’t glaucomatous, and increased rim thickness would not be expected in glaucoma.

Glaucoma characteristically causes excavation of the optic nerve head, or cupping, driven by loss of retinal ganglion cell axons and remodeling at the lamina cribrosa. As these nerve fibers deteriorate, the neuroretinal rim thins and the cup enlarges relative to the disc, often most evident in the inferior and superior regions. With progression, pallor of the remaining neuroretinal tissue can appear as the rim becomes thinner. This combination—cupping with thinning of the neuroretinal rim (and possible pallor)—is the classic optic nerve head change in glaucoma. In contrast, disc swelling with hemorrhages points to optic neuritis or papilledema, no structural change isn’t glaucomatous, and increased rim thickness would not be expected in glaucoma.