To investigate the measurement repeatability of peripapillary atrophy (PPA) parameters obtained by optic disc stereophotography (ODP) and evaluate the usefulness of PPA parameters to differentiate open-angle glaucoma (OAG) from normal eyes in patients with PPA.

Sixty-five eyes of 65 patients with PPA were examined. Disc area, cup area, rim area, vertical cup to disc (CD) ratio, CD area ratio, PPA area, zone beta (β) area and zone alpha (α) area were obtained by ODP using intrinsic algorithms. The area under the receivers operating characteristic (AUROC) curves was used to compare the PPA parameters with that of the disc parameters to differentiate OAG from normal eyes. Two examiners analyzed PPA parameters to confirm reproducibility and repeatability of ODP.

Vertical CD ratio (VCD), area CD ratio, zone β area, zone β area per PPA area, zone β area per disc area and axial length were significantly larger in OAG patients ( p < 0.05). Among PPA parameters, zone β area per PPA area was strongly correlated with MD (r =-0.431) and PSD (r = 0.411). In addition, PPA (area) to disc area ratio showed the best diagnostic ability (AUROC curve value of 0.786) when comparing the OAG group to the normal group. PPA area and zone β area obtained by ODP showed good reproducibility and repeatability (ICC > 0.997).

The PPA measurement obtained by ODP has good reproducibility and consistency and can be a useful tool in monitoring PPA changes in glaucoma patients.