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AIM: To investigate the relationship of the change of peripapillary atrophy β zone and progress of optic disc damage in primary open angle glaucoma(POAG).<p>METHODS: In this retrospective study, 66 eyes of 44 POAG subjects were selceted and made the morphology evaluation of the color fundus photographs(30°)which were taken in baseline and five-year visit. The change of peripapillary atrophy β zone(β zone)and the progress of optic disc damage was detected. The disc rim/disc area ratio, β zone/disc area ratio and vertical cup/disc ratio both baseline was calculated by computer software.<p>RESULTS:Forty-eighty eyes had β zone in 66 POAG subjects in baseline, β zone of 20 eyes(42%)was expanded, there was no significant difference on age, refractive error, gender, vertical cup/disc ratio, rim/disc area ratio, β zone/disc area ratio of baseline between β zone-developed group and β zone-undeveloped group. After excluded the eyes' refractive error >-3.00D, β zone of 15 eyes(60%)had developed in 25 progressed glaucoma eyes and 4 eyes(21%)had undeveloped in 19 unprogressed glaucoma eyes. There was significantly different(<i>χ</i>²=6.67, <i>P</i>=0.011).<p>CONCLUSION: The prevalence of β zone development in progressed group is larger than unprogressed group in POAG. To monitor the change of β zone may have some effects in predicting the progress of POAG.