Effect of Focal Lamina Cribrosa Defect on Glaucomatous Visual Field Progression

Faridi, Omar S.; Park, Sung Chul; Kabadi, Rajiv A.; Su, Daniel; Moraes, Carlos Gustavo De; Liebmann, Jeffrey M.; Ritch, Robert

doi:10.1016/j.ophtha.2014.02.017

Cited by 86 publications

(74 citation statements)

References 39 publications

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“…Lamina cribosas with radially oriented capillaries at the peripheral region had higher average oxygen concentration than those with isotropic or circumferential configurations. Note that human LCs naturally exhibit a radial arrangement of the microcapillaries at the periphery 31 and any deviations from such an arrangement (possible through focal defects 55 ) may contribute to the development of OAG.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Lamina Cribrosa Microcapillary Hemodynamics and Oxygen Concentrations

Chuangsuwanich

Birgersson

Thiéry

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To identify and rank the lamina cribrosa (LC) morphologic factors that influence LC microcapillary hemodynamics and oxygen concentrations using computational fluid dynamics (CFD).METHODS. We generated 12,000 'artificial' LC microcapillary networks and predicted blood flow velocities and oxygen concentrations within the microcapillaries using CFD. Across models, we varied the average pore size of the LC (5500 6 2400 lm 2 ), the microcapillary arrangement (radial, isotropic, or circumferential), the LC diameter (1.9 6 0.3 mm), the inferior-superior curvature (340 6 116 m À1 ), and the nasal-temporal curvature (À78 6 130 m À1 ). We assumed that blood flow originated from the Circle of Zinn-Haller, fed the LC uniformly at its periphery, and was drained into the central retinal vein. Arterial (50 6 6 mm Hg) and venous (17.7 6 6 mm Hg) pressures were applied as boundary conditions and were also varied within our simulations. Finally, we performed linear regression analysis to rank the influence of each factor on LC hemodynamics and oxygen concentrations. RESULTS.The factors influencing LC hemodynamics and oxygen concentrations the most were: LC diameter, arterial pressure, and venous pressure, and to a lesser extent: the microcapillary arrangement (anisotropy) and nasal-temporal curvature. Lamina cribrosa pore size and superior-inferior curvature had almost no impact. Specifically, we found that LCs with a smaller diameter, a radial arrangement of the microcapillaries, an elevated arterial pressure and a decreased venous pressure had higher oxygen concentrations across their networks.CONCLUSION. This study described LC hemodynamics using a computational modeling approach. Our study may provide clinically relevant information for the understanding of ischemia-induced neuronal cell death in optic neuropathies.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing Lamina Cribrosa Microcapillary Hemodynamics and Oxygen Concentrations

Chuangsuwanich

Birgersson

Thiéry

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…The longitudinal detection of anterior laminar insertion migration 17 is therefore important for two reasons. First, using current OCT imaging, it may be linked to nerve fiber layer (NFL) hemorrhages, 16 NFL defects, 34 visual field progression, 35 and the development of acquired optic disc pits. 36 Second, it may confirm the relative timing of its direction (i.e., inward during initial deformation, outward as deformation progresses) suggested by our cross-sectional findings.…”

Section: Discussionmentioning

confidence: 99%

The Connective Tissue Components of Optic Nerve Head Cupping in Monkey Experimental Glaucoma Part 1: Global Change

Yang

Ren

Lockwood

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…10 In addition, lamina cribrosa (LC) defects or thinning is associated with glaucoma. [11][12][13][14][15][16] The LC stabilizes intraocular pressure (IOP) by forming a barrier between the intraocular space and the extraocular space, and it has been considered the principal site of retinal ganglion cell mechanical axonal injury in glaucomatous damage. 17 Burgoyne 18 has proposed that only ''laminar'' or ''deep'' forms of ONH cupping are pathognomonic for glaucoma and that laminar deformation in nonglaucomatous optic neuropathy, such as that induced by experimentally reduced cerebrospinal fluid pressure in monkeys, might be minimal.…”

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confidence: 99%

“…Recent studies show that the LC is posteriorly located and significantly thinner in patients with glaucoma than in healthy controls. [11][12][13][14][15] Recently, one study evaluated deep optic nerve structures in NAION eyes after an ischemic attack compared to normal-tension glaucoma eyes. The authors found a striking difference in the deep ONH configuration between glaucoma and NAION.…”

mentioning

confidence: 99%

Optic Nerve Head Morphology in Nonarteritic Anterior Ischemic Optic Neuropathy Compared to Open-Angle Glaucoma

Fard

Afzali

Abdi

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Fard MA, Afzali M, Abdi P, et al. Optic nerve head morphology in nonarteritic anterior ischemic optic neuropathy compared to open-angle glaucoma. Invest Ophthalmol Vis Sci. 2016;57:4632-4640. DOI:10.1167/ iovs.16-19442 PURPOSE. To compare optic nerve head (ONH) morphology of optic nerve atrophy between eyes with primary open-angle glaucoma (POAG) and eyes with a history of nonarteritic anterior ischemic optic atrophy (NAION) using enhanced depth imaging (EDI) with spectraldomain optical coherence tomography (SD-OCT). METHODS.In this cross-sectional study, 121 eyes of 91 patients consisted of moderate to severe POAG (n ¼ 32 eyes), visual field mean deviation-matched NAION (n ¼ 30 eyes) and their fellow eyes (n ¼ 30 eyes), and healthy controls (n ¼ 29). The optic discs were scanned using SD-OCT and measurements were obtained using HEYEX software 6.0. Lamina cribrosa (LC) thickness and anterior lamina cribrosa depth (ALD) at three scans (midsuperior, central, and midinferior) were determined and compared. In addition, prelaminar tissue thickness was measured at three points of a single central scan.RESULTS. There was no significant difference in the visual field mean deviation (MD) between the NAION and POAG groups (P > 0.99), but both groups had a significantly worse MD than the healthy group (P < 0.001). The NAION and POAG groups had similar peripapillary retinal nerve fiber layer (pRNFL) thickness (P < 0.99). Eyes with POAG had greater ALD and thinner LC than control eyes and NAION eyes in all regions of the ONH (P < 0.001 for both). There was a marked prelaminar tissue thinning in POAG eyes compared to control and NAION eyes (P < 0.001). Lamina cribrosa thickness and ALD of NAION eyes were not different from their fellow eyes and control eyes. Although prelaminar thickness was thinner in NAION eyes compared to their fellow eyes (P ¼ 0.005), it was thicker than in control eyes (P < 0.001).CONCLUSIONS. Despite profound thinning and posterior displacement of LC in POAG, the thickness and position of LC in NAION eyes are similar to those seen in healthy control and their fellow eyes.Keywords: open-angle glaucoma, nonarteritic anterior ischemic optic atrophy, lamina cribrosa, optic nerve head, optic atrophy B oth open-angle glaucoma (OAG) as chronic progressive optic neuropathy and nonarteritic anterior ischemic optic neuropathy (NAION) as acute optic neuropathy with inflammation-associated axonal loss cause irreversible damage to the optic nerve.1-3 In contrast to NAION, which presents with disc pallor after an ischemic event, OAG results in the enlargement of the optic disc cup. Optic nerve head (ONH) morphologic features differ in NAION and OAG. While a small disc area and smaller cupping are predisposing risk factors for the development of NAION, [3][4][5]

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Effect of Focal Lamina Cribrosa Defect on Glaucomatous Visual Field Progression

Cited by 86 publications

References 39 publications

Factors Influencing Lamina Cribrosa Microcapillary Hemodynamics and Oxygen Concentrations

Factors Influencing Lamina Cribrosa Microcapillary Hemodynamics and Oxygen Concentrations

The Connective Tissue Components of Optic Nerve Head Cupping in Monkey Experimental Glaucoma Part 1: Global Change

Optic Nerve Head Morphology in Nonarteritic Anterior Ischemic Optic Neuropathy Compared to Open-Angle Glaucoma

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