Peripapillary chorioretinal atrophy or peripapillary atrophy has been reported to be more frequently present and extensive in eyes with high-tension glaucoma than in healthy eyes. Peripapillary atrophy has been divided into a central zone (zone beta)—characterized by retinal pigment epithelial loss and choroidal atrophy with visible large choroidal vessels and sclera—and a peripheral zone (zone alpha) with irregular hyper- and hypo-pigmentation. Peripapillary atrophy can also be divided into congenital and acquired atrophy. Peripapillary atrophy is associated with the optic nerve damage because the prelaminar portion of the optic nerve head receives its main blood supply from the peripapillary choroid via branches of short posterior ciliary arteries with characteristic sectoral distribution, the absence or dysfunction of that centripetal branch in the sector of peripapillary atrophy will cause ischemic optic nerve head damage in that segment.