Peripapillary

Peripapillary is an anatomical term used in ophthalmology and neuro-ophthalmology to describe structures located around the optic disc, the point where retinal ganglion cell axons converge to form the optic nerve as it exits the eye. The peripapillary region surrounds the disc and includes adjacent retinal, choroidal, and scleral tissues. This area is routinely evaluated because its appearance and measurements can reflect changes in the optic nerve head and nearby retina.

Anatomy and subregions: The peripapillary retina contains the peripapillary nerve fiber layer, whose thickness is a key parameter in assessing axonal integrity. The parapapillary sclera and overlying choroid form the supportive ring around the disc. Peripapillary atrophy (PPA) is a related finding characterized by alterations in the retinal pigment epithelium and choriocapillaris, and it is commonly subdivided into alpha and beta zones. Variation in these tissues, including the degree of atrophy and the contour of the parapapillary region, can influence imaging and interpretation of the optic nerve head.

Clinical significance: Peripapillary measurements, especially the thickness of the peripapillary nerve fiber layer, are central to glaucoma evaluation and monitoring. Thinning around the optic disc can indicate glaucomatous damage or other optic neuropathies. Peripapillary atrophy is associated with myopia and various optic nerve conditions and can complicate imaging analysis. Modern imaging modalities such as optical coherence tomography (OCT) and fundus photography focus routinely on the peripapillary area to help diagnose, quantify, and track disease progression.