Posterior Displacement of the Lamina Cribrosa in Glaucoma: In Vivo Interindividual and Intereye Comparisons

Furlanetto, Rafael; Park, Sung Chul; Damle, Uma; Sieminski, Sandra; Kung, Yungtai; Siegal, Nora; Liebmann, Jeffrey M.; Ritch, Robert

doi:10.1167/iovs.12-11530

Cited by 101 publications

(112 citation statements)

References 35 publications

(73 reference statements)

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“…Their subsequent study found a more posterior location of central and mid-peripheral LC in glaucomatous than in healthy eyes. 20 The present data consistently exhibited, via SS-OCT scans, verticalhorizontal PLCD difference in healthy eyes. Further, the present study explored, for the first time using SS-OCT, the increased vertical-horizontal PLCD difference in POAG eyes compared with age-matched healthy eyes.…”

Section: Discussionsupporting

confidence: 82%

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source optical coherence tomography study of lamina cribrosa

Kim

Jeoung

et al. 2015

Eye

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Purpose To investigate peripheral lamina cribrosa depth (PLCD) and its verticalhorizontal difference in eyes with primary open-angle glaucoma (POAG). Methods Patients with POAG (n = 90 eyes) and age-matched healthy individuals (n = 90 eyes) underwent swept-source optical coherence tomography (SS-OCT) scans centered at the optic discs. The PLCD was defined as the vertical distance between the most peripheral visible end of anterior lamina cribrosa (LC) surface and the reference plane connecting the Bruch's membrane openings. The PLCD in each quadrant region and the vertical-horizontal PLCD difference were compared between the POAG and healthy eyes. The clinical factors associated with increased PLCD were evaluated. Results The PLCD was significantly larger in the POAG eyes than the control eyes at the horizontal (P = 0.034) and vertical (P = 0.001) meridians. The vertical PLCD was significantly larger than the horizontal PLCD, both in the POAG eyes (Po0.001) and in the control eyes (P = 0.003). However, the vertical-horizontal PLCD difference was significantly larger in the POAG eyes (47 ± 60 μm) than in the control eyes (18 ± 54 μm, P = 0.001). Multivariate regression showed a significant association of male gender (P = 0.005), increased baseline IOP (P = 0.043), and decreased MD of VF (P = 0.025) with increased PLCD. Conclusions The peripheral LC was displaced more posteriorly in the POAG eyes compared with the age-matched healthy eyes. In the POAG eyes, the peripheral LC was displaced more posteriorly at the vertical meridian than at the horizontal meridian. The peripheral LC in the vertical meridian might have increased IOP-related strain (deformation) compared with horizontal meridian in glaucomatous eyes.

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Section: Discussionsupporting

confidence: 82%

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source optical coherence tomography study of lamina cribrosa

Kim

Jeoung

et al. 2015

Eye

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“…posterior sclera, may affect tissue responses in a way that would diminish pressure-related conformational changes in older patients with severe glaucoma. 15 LC is located more deeply in glaucomatous eyes 7 ; thus, postoperative edema of the ONH and the choroid could theoretically be an additional contributory factor to the early cupping reversal, as previously suggested by Greenidge et al 2 and Spaeth et al 29 In our cohort, IOP was successfully reduced to a presumably safe 30 level (11.5 -2.6 mmHg). Konstas et al 31 evaluated the 24-h IOP in patients with OAG treated with trabeculectomy versus maximal tolerated medical therapy and found that a successful trabeculectomy provides statistically lower mean, peak, and range of IOP for the 24-h period than maximal tolerated medical therapy in advanced glaucoma patients.…”

Section: Figsupporting

confidence: 76%

“…A straight reference line (RL) was drawn by one investigator (AR) masked to scan order between opposite edges of the opening in Bruch's membrane. 6,7,12,20 For study purposes, the cup area was defined as the cross-sectional optic disc area circumscribed by the RL (vitreal side) and the prelaminar tissue (toward the LC). Then, the uniformly dark area was automatically identified by Photoshop using the Color Selection tool with a tolerance of eight ( Fig.…”

Section: Image and Data Analysismentioning

confidence: 99%

“…[1][2][3][4][5] Biomechanical factors that affect the optic nerve head (ONH) may strongly influence the glaucomatous process because the posterior sclera and lamina cribrosa (LC) are implicated in the pathophysiology of glaucomatous optic neuropathy. 6,7 Stereoscopic optic disc photography and scanning laser tomography have been widely used to study optic disc cupping reversal in adults after IOP reduction. Although neural rim thickening and cup decrease have been well documented, the timing and duration of these changes remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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Topographic Optic Disc Changes After Successful Trabeculectomy Evaluated Using Spectral Domain Optical Coherence Tomography

Russo

Katsanos

Riva

et al. 2013

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To investigate topographic optic disc changes after surgical intraocular pressure (IOP) reduction in adults with open angle glaucoma (OAG). Methods: Optic discs of patients with advanced primary open angle or exfoliation glaucoma were imaged using optical coherence tomography within 1 week before trabeculectomy. Patients were rescanned 1 week, 1 month, and 1 year after surgery. Maximum cup depth (MCD), and average cup depth (ACD) were calculated. Results: Twenty-two eyes from 20 patients (age, 70.5 -10.6 years; average mean defect of visual field, -15.0 -9.8 dB) were followed up for 1 year. The IOP decreased from 22.1 -2.8 mmHg at baseline to 11.5 -2.6 mmHg 1 year following surgery (P < 0.001). One-week and 1-month postoperative IOPs were 11.2 -2.8 and 11.2 -3.5 mmHg, respectively (P < 0.001). Compared to the baseline values (356 -172 mm), postoperative ACD showed a significant decrease at 1 week (312 -164 mm; P < 0.001) and 1 month (338 -175 mm; P = 0.007) after surgery, but not at 1 year (339 -176 mm; P = 0.354). Similarly, MCD significantly decreased from baseline (477 -190 mm) 1 week (431 -203 mm; P = 0.029) and 1 month (448 -198 mm; P = 0.047) after the surgery, but not after 1 year (479 -188 mm; P = 1.0). Conclusions: Trabeculectomy reduces IOP in eyes with advanced OAG, which induces topographic optic disc changes. Such optic disc changes became less pronounced over time and were no longer detectable 1 year after surgery.

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“…6 The LC is located more posteriorly within the ONH in glaucomatous eyes than in healthy eyes, based on histologic studies using glaucomatous eyes or in vivo studies using enhanced depth imaging optical coherence tomography (EDI OCT). [7][8][9] Therefore, a deep LC may indicate that the ONH has been put under substantial mechanical stress.…”

mentioning

confidence: 99%

Factors Affecting Plastic Lamina Cribrosa Displacement in Glaucoma Patients

Jung

Park

et al. 2014

Investigative Ophthalmology & Visual Science

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PURPOSE.To investigate factors associated with irreversible components of anterior lamina cribrosa (LC) depth in glaucoma patients. METHODS.A total of 141 glaucoma patients and 51 healthy control subjects were enrolled. The optic nerve head (ONH) was imaged using the enhanced depth imaging (EDI) modes of Spectralis optical coherence tomography (OCT). The depth of the LC was measured at the midhorizontal, superior, and inferior midperipheral regions of the ONH of each eye. Analyzed factors associated LC depth included age, axial length, intraocular pressure (IOP), disc size, central corneal thickness, average retinal nerve fiber layer (RNFL) thickness, and mean deviation (MD). RESULTS.In glaucoma patients, the LC was more deeply located compared with the control group at the midhorizontal and superior and inferior midperipheral B-scans (All P < 0.001). Age, initial IOP, and treated IOP was correlated with mean LC depth (All P < 0.001), and those correlations remained after adjusting for MD and RNFL thickness (All P < 0.001). In multivariate analysis, younger age, high untreated IOP, and thinner RNFL thickness was significantly associated with a deeper LC (P ¼ 0.015, <0.001, and 0.042). There was an interaction between age and MD as predictors for LC depth (P ¼ 0.007).CONCLUSIONS. The anterior LC surface is more deeply located in glaucoma patients compared with healthy controls. In glaucoma patients, age, initial IOP, and RNFL thickness were influential factors related to LC depth. These factors should be considered in clinical application of plastic LC displacement in glaucoma patients.

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Posterior Displacement of the Lamina Cribrosa in Glaucoma: In Vivo Interindividual and Intereye Comparisons

Cited by 101 publications

References 35 publications

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source optical coherence tomography study of lamina cribrosa

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source optical coherence tomography study of lamina cribrosa

Topographic Optic Disc Changes After Successful Trabeculectomy Evaluated Using Spectral Domain Optical Coherence Tomography

Factors Affecting Plastic Lamina Cribrosa Displacement in Glaucoma Patients

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