To explore the morphological characteristics of cup and plate structures in glaucoma patients and their differences from those in non glaucoma patients.

The 288 patients (288 eyes) who underwent fundus photography examination at the outpatient department of Beijing Tongren Hospital affiliated to Capital Medical University from November 2024 to September 2025 were collected and completed the nipple analysis system detection. Among them, there were 146 males (146 eyes) and 142 females (142 eyes) with an average age of (39.1±15.2) years (ranging from 10 to 71 years old). All patients underwent intraocular pressure, ocular biological measurements, fundus imaging examination, and analysis of the optic disc analysis system. Patients were divided into glaucoma group and non glaucoma group based on their history of glaucoma and clinical manifestations such as enlargement of the optic cup, loss of disc edge, typical atrophic changes in the optic nerve fiber layer, and visual field defects in fundus images. Age, axial length, disc edge area, and vertical width of the optic disc were tested to follow a normal distribution, represented by ±s. Independent sample t-test was used for inter group comparison. The intraocular pressure, central corneal thickness, anterior depth, lens thickness, average corneal curvature radius, pupil diameter, disc edge width in each region, disc edge to disc area ratio, disc edge volume, vertical cup to disc ratio, cup area, cup to disc area ratio, cup volume, average cup depth, maximum cup depth, disc area, disc volume, and likelihood of disc damage scores do not followed a normal distribution and were represented by M (Q1, Q3). Mann Whitney U test was used for inter group comparison.

Among the total 288 patients (288 eyes), there were 241 patients (241 eyes) in the non glaucoma group and 47 patients (47 eyes) in the glaucoma group, accounting for 83.7% and 16.3%, respectively. The intraocular pressure of patients in the non glaucoma group and glaucoma group was 16.7 (14.0, 19.0)mmHg (1 mmHg=0.133 kPa) and 21.9 (17.2, 25.3)mmHg, respectively. The non glaucoma group was lower than the glaucoma group, and the difference was statistically significant (Z=-5.49, P<0.05). The width, area, and ratio of optic disc area from point A to point F in the non glaucoma group were 0.18 (0.14, 0.21)mm, 0.20 (0.15, 0.25)mm, 0.22 (0.16, 0.29)mm, 0.24 (0.17, 0.33)mm, 0.25 (0.18, 0.33)mm, 0.22 (0.16, 0.27)mm, 0.15 (0.11, 0.18)mm, (1.23±0.36)mm^2, and 0.68 (0.54, 0.81)mm, respectively. The glaucoma group had 0.12 (0.09, 0.16)mm, 0.16 (0.09, 0.20)mm, and 0.16 (0.11, 0.24)mm, 0.19 (0.12, 0.24)mm, 0.16 (0.11, 0.24)mm, 0.13 (0.08, 0.20)mm, 0.10 (0.05, 0.14)mm, (0.94±0.34)mm^2, and 0.52 (0.38, 0.67)mm, respectively. Those were all larger in the non glaucoma group than in the glaucoma group, and the differences were statistically significant (Z/t=-4.70, -4.05, -3.33, -3.59, -4.37, -4.55, -4.18, 5.35, -4.32; P<0.05). The vertical cup to disc ratio, cup area, cup to disc area ratio, cup volume, average cup depth, and maximum cup depth in non glaucoma patients were 0.55 (0.44, 0.65), 0.58 (0.30, 1.11)mm^2, 0.32 (0.19, 0.46), 0.08 (0.02, 0.22)mm^3, 0.14 (0.08, 0.22)mm, 0.36 (0.23, 0.52)mm, 2.00 (2.00, 3.00), while the glaucoma patients were 0.69 (0.58, 0.81), 1.05 (0.52, 1.35)mm^2, 0.48 (0.33, 0.62), 0.16 (0.07, 0.33)mm^3, 0.18 (0.11, 0.26)mm, 0.43 (0.33, 0.60)mm, and 3.00 (3.00, 3.00)mm were all lower in the non glaucoma group than those in the glaucoma group, and the differences were statistically significant (Z=-4.47, -2.91, -4.32, -2.88, -2.17, -2.41, -6.36; P<0.05). 159 cases (159 eyes) of non glaucoma patients were distributed near temporal 0° or 360°, accounting for 65.98%; there were 53 cases (53 eyes) distributed near 300° below the temporal lobe and 60° above the temporal lobe, accounting for 21.99%; 29 cases (29 eyes) were distributed in other parts, accounting for 12.03%. 22 cases (22 eyes) of glaucoma patients were distributed near 300° below the temporal lobe and 40° above the temporal lobe, accounting for 46.81%; 25 cases (25 eyes) were distributed in other parts, accounting for 53.19%.

The narrowest part of the optic disc in patients with physiological large optic cups is mainly distributed near the temporal side at 0° or 360°, while in the glaucoma group, nearly half of the affected eyes are concentrated near 300° below and 40° above the temporal side, with scattered distribution in other areas. The rim of glaucoma affected eyes is narrower, with a smaller ratio of rim area to optic disc area. The vertical cup to disc ratio, cup to disc area ratio, cup to disc volume, and cup depth are larger.