Violation of the ISNT rule in Nonglaucomatous pediatric optic disc cupping.

@article{Pogrebniak2010ViolationOT,
  title={Violation of the ISNT rule in Nonglaucomatous pediatric optic disc cupping.},
  author={Alexander E. Pogrebniak and Ben Wehrung and Katherine L. Pogrebniak and Rajesh K. Shetty and Pam Crawford},
  journal={Investigative ophthalmology \& visual science},
  year={2010},
  volume={51 2},
  pages={
          890-5
        }
}
PURPOSE To determine whether nonglaucomatous optic disc cupping in children violates the ISNT rule (which states that for normal optic discs the neuroretinal rim width is greatest in the order inferior >or= superior >or= nasal >or= temporal). METHODS Digital ocular fundus photographs from a random cohort of children with large optic disc cups of nonglaucomatous origin were analyzed in masked fashion by using computer graphic software. The diameter and perimeter of each optic disc and optic… 
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26 Citations
Background Citations
5
Methods Citations
2
Results Citations
2

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Clinical characteristics of nonglaucomatous optic disc cupping
TLDR
The key features that differentiated NGODC from GODC were the color of the optic disc rim and the correlation between visual field defects and the disc appearance, which aided in distinguishing between the two disorders.
Evaluation of the “IS” Rule to Differentiate Glaucomatous Eyes From Normal
TLDR
The ISNT rule alone has a high sensitivity but relatively low specificity but a combination of different features of the optic disc (increase of CDR and ISNT or IS rule) improves the specificity of optic disc evaluation for glaucoma.
Effect of Age and Disc Size on Rim Order Rules by Heidelberg Retina Tomograph
TLDR
TheISNT rule does not apply to neuroretinal rim area as measured by HRT, as only 18% of the eyes complied with the ISNT rule in this normative database, and the IS and IST rules seem to better represent the normative database.
Influence of Optic Disc Size on Identifying Glaucomatous Optic Neuropathy.
TLDR
Accurate identification of glaucomatous optic neuropathy was significantly influenced by optic disc size and the ISNT rule, and this was particularly evident for the large normal nerve and the small glaucatous nerve.
Applicability of ISNT Rule Using Bruch's Membrane Opening-based Optic Nerve Head Parameters
TLDR
BMO-based optic nerve head parameters exhibited higher diagnostic power for differentiating between normal and glaucomatous eyes based on the ISNT rule, compared with the classic method of using disc photographs.
Nasalised distribution of peripapillary retinal nerve fibre layers in large discs
TLDR
Results from this study could observe nasalisation of the peripapillary RNFL and superior retinal artery in patients with a large disc, which may help prevent misdiagnosis of glaucoma and improve the sensitivity and specificity of glAUcoma detection.
The accuracy of the inferior>superior>nasal>temporal neuroretinal rim area rule for diagnosing glaucomatous optic disc damage.
Application of the ISNT Rule to Neuroretinal Rim Thickness Determined Using Cirrus HD Optical Coherence Tomography
TLDR
The ISNT rule with rim thickness measured using Cirrus HD-OCT has limited clinical value in the diagnosis of glaucoma, and there is a topographic difference in inferior rim loss according to the stages ofglaucomatous damage.
ISNT rule satisfaction in Korean non-glaucomatous subjects
TLDR
The cup was absent in 15% of the assessed eyes, and the inferior was the most common quadrant with the thickest neuroretinal rim and the temporal, the thinnest, in eyes violating the ISNT rule.
A Case Report on Premature Twins: Primary Congenital Glaucoma or Large Cupping Disks Mimicking Primary Congenital Glaucoma?
TLDR
It is concluded that the early birth and lower birth weights may have been associated with the large cupping of the patients’ optic disks, and to differentiate between normal physiological cupping and primary congenital glaucoma, ocular morphological examination of the eye, IOP measurements, and investigation of the parents' optic disks were useful.
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