The Anatomy and Pathophysiology of the Optic Nerve Head in Glaucoma

Burgoyne, Claude F.; Morrison, John C.

doi:10.1097/00061198-200110001-00007

Cited by 85 publications

(59 citation statements)

References 8 publications

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“…34 In the parapapillary region, highly axially myopic eyes show, in addition to the parapapillary gamma zone, a marked elongation and corresponding thinning of the peripapillary scleral flange. 35 If the normal thickness of the flange is about 0.40 mm, it can get reduced to 50 mm in highly axially myopic eyes, parallel to an elongation of about 0.5-5.0 mm. As the peripapillary scleral flange is the biomechanical anchor of the lamina cribrosa, any weakening of the flange, such as thinning, may have a consequence for the biomechanical stability of the lamina cribrosa and the fibers passing through it.…”

Section: Optic Nerve Headmentioning

confidence: 99%

Histological changes of high axial myopia

Jonas

2013

Eye

121

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To describe pathological changes in the anatomy of highly myopic (axially elongated) eyes, enucleated globes were examined by light microscopy and ocular structures were measured histomorphometrically. These studies revealed that highly axially myopic eyes show continuous thinning of the sclera starting at or behind the equator with a maximal thinning at the posterior pole; a profound thinning of the choroid decreasing from B250 to o10 mm in extreme axial myopia, secondary macular defects in the Bruch's membrane associated with a complete loss of retinal pigment epithelium and choriocapillaris, and retinal photoreceptors; a Bruch's membrane of normal thickness in contrast to the profound thinning of the choroid and the sclera; an up to 10-fold elongation and thinning of the peripapillary scleral flange as anterior roof of the orbital cerebrospinal fluid space, and subsequently a retrobulbar extension of the cerebrospinal fluid space; an increased distance of the peripapillary arterial circle of Zinn-Haller to the optic disc border; an elongation and thinning of the lamina cribrosa with a subsequently decreased distance between the intraocular pressure compartment and the retrobulbar orbital cerebrospinal fluid pressure compartment; an increasing exposure of the peripheral posterior lamina cribrosa surface to the cerebrospinal fluid space, no longer buffered by the solid optic nerve tissue; and the development and enlargement of parapapillary gamma zone, in contrast to a myopia-independent parapapillary beta zone. These anatomical changes may be associated with high axial myopia-related complications such as an increased susceptibility of glaucomatous optic neuropathy and myopic retinopathy.

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Section: Optic Nerve Headmentioning

confidence: 99%

Histological changes of high axial myopia

Jonas

2013

Eye

121

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“…34 The absence of optic nerve cupping in diabetes reinforces the idea that glaucoma is not a disease that originates with retinal ganglion cell damage, rather that it is the sequela of some event in the optic nerve that causes retinal ganglion cell damage, such as a disturbance in the lamina cribrosa. 2,35,36 The prevalence of diabetes in a recent survey of the US population in 2000 was estimated at 7.3%. 37 As noted by Takahashi et al, 27 when patients with diabetes are being evaluated for glaucoma, one must keep in mind that the RNFL may be thin from diabetes itself.…”

Section: Optic Nerve Head Gradingmentioning

confidence: 99%

Effect of Diabetic Retinopathy and Panretinal Photocoagulation on Retinal Nerve Fiber Layer and Optic Nerve Appearance

et al. 2009

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“…It has remained unclear whether a thin cornea was a clinical diagnostic risk factor because the falsely low intraocular pressure measurements were not sufficiently corrected for their dependence on central corneal thickness, or whether a thin cornea was additionally a structural risk factor, potentially due to an association between a thin cornea and a thin lamina cribrosa. According to biomechanical considerations, a thin lamina cribrosa may be a risk factor for increased glaucoma susceptibility [4,5].…”

mentioning

confidence: 99%

Central corneal thickness, lamina cribrosa and peripapillary scleral histomorphometry in non-glaucomatous chinese eyes

Ren

Gao

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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In Chinese, central corneal thickness is not significantly correlated with the thickness of the central and peripheral lamina cribrosa and the thickness of the peripapillary sclera nor with the shortest distance between the intraocular space and the cerebrospinal fluid space. These histomorphometric data do not support a relationship between central corneal thickness and thickness of structures of the optic nerve head, and thus do not support an association between a thin cornea and increased structural glaucoma susceptibility.

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The Anatomy and Pathophysiology of the Optic Nerve Head in Glaucoma

Cited by 85 publications

References 8 publications

Histological changes of high axial myopia

Histological changes of high axial myopia

Effect of Diabetic Retinopathy and Panretinal Photocoagulation on Retinal Nerve Fiber Layer and Optic Nerve Appearance

Central corneal thickness, lamina cribrosa and peripapillary scleral histomorphometry in non-glaucomatous chinese eyes

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