Three dimensional analysis of the lamina cribrosa in glaucoma

Morgan-Davies, Justin; Taylor, Nigel; Hill, A; Aspinall, Peter; O’Brien, Colm; Azuara‐Blanco, Augusto

doi:10.1136/bjo.2003.036020

Cited by 31 publications

(20 citation statements)

References 17 publications

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“…19-21 These changes are thought to contribute to glaucomatous retinal ganglion cell loss in as a result of mechanical pressure on retinal ganglion cell axons passing through the lamina pores. 19,22,23 Hysteresis is a physical property related to the ability of connective tissues to dampen pressure changes. As the cornea and sclera are contiguous parts of the corneo-scleral envelope, formed from continuous extracellular matrix, 24 deformability of the cornea and sclera are likely to be closely related.…”

Section: Discussionmentioning

confidence: 99%

Corneal Hysteresis and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma

Zhang

Tatham

Abe

et al. 2016

American Journal of Ophthalmology

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Purpose To investigate the relationship between corneal hysteresis (CH) and progressive retinal nerve fiber layer (RNFL) loss in a cohort of patients with glaucoma followed prospectively over time. Design Prospective observational cohort study. Methods One-hundred and eighty-six eyes of 133 patients with glaucoma followed for an average of 3.8 ± 0.8 years, with a median of 9 visits during follow-up. The CH measurements were acquired using the Ocular Response Analyzer (Reichert Instruments, Depew, NY) and RNFL measurements were obtained at each follow up visit using spectral domain optical coherence tomography (SD-OCT). Random-coefficient models were used to investigate the relationship between baseline CH, central corneal thickness (CCT), average intraocular pressure (IOP) and rates of RNFL loss during follow up, while adjusting for potentially confounding factors. Results Average baseline RNFL thickness was 76.4 ± 18.1 μm and average baseline CH 9.2 ± 1.8 mmHg. CH had a significant effect on rates of RNFL progression. In the univariable model, including only CH as a predictive factor along with time and their interaction, each 1 mmHg lower CH was associated with a 0.13 μm/year faster rate of RNFL decline (P=0.011). A similar relationship between low CH and faster rates of RNFL loss was found using a multivariable model accounting for age, race, average IOP and CCT (P=0.015). Conclusions Lower CH was significantly associated with faster rates of RNFL loss over time. The prospective longitudinal design of this study provides further evidence that CH is an important factor to be considered in the assessment of the risk of progression in patients with glaucoma.

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Section: Discussionmentioning

confidence: 99%

Corneal Hysteresis and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma

Zhang

Tatham

Abe

et al. 2016

American Journal of Ophthalmology

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“…Additionally, the LC was noted in several OCT studies to displace posteriorly in glaucomatous eyes compared to age-matched healthy eyes (Kim et al, 2015; Sawada et al, 2015; Jung et al, 2016) and thinner LC was associated with glaucoma progression (Chung et al, 2015). Overall, the structural thinning, pore deformities and posterior displacement of the LC (Morgan-Davies et al, 2004), likely impede axoplasmic flow within the optic nerve fibers which will impair survival of RGCs (Burgoyne, 2011; Quigley, 2011). This could lead to RGC apoptosis, contributing to glaucoma development and progression.…”

Section: The Expanding Role Of Ao-octmentioning

confidence: 99%

Adaptive optics optical coherence tomography in glaucoma

Dong

Wollstein

Wang

et al. 2017

Progress in Retinal and Eye Research

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Since the introduction of commercial optical coherence tomography (OCT) systems, the ophthalmic imaging modality has rapidly expanded and it has since changed the paradigm of visualization of the retina and revolutionized the management and diagnosis of neuro-retinal diseases, including glaucoma. OCT remains a dynamic and evolving imaging modality, growing from time-domain OCT to the improved spectral-domain OCT, adapting novel image analysis and processing methods, and onto the newer swept-source OCT and the implementation of adaptive optics (AO) into OCT. The incorporation of AO into ophthalmic imaging modalities has enhanced OCT by improving image resolution and quality, particularly in the posterior segment of the eye. Although OCT previously captured in-vivo cross-sectional images with unparalleled high resolution in the axial direction, monochromatic aberrations of the eye limit transverse or lateral resolution to about 15-20 μm and reduce overall image quality. In pairing AO technology with OCT, it is now possible to obtain diffraction-limited resolution images of the optic nerve head and retina in three-dimensions, increasing resolution down to a theoretical 3 μm3. It is now possible to visualize discrete structures within the posterior eye, such as photoreceptors, retinal nerve fiber layer bundles, the lamina cribrosa, and other structures relevant to glaucoma. Despite its limitations and barriers to widespread commercialization, the expanding role of AO in OCT is propelling this technology into clinical trials and onto becoming an invaluable modality in the clinician's arsenal.

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“…The mechanical theory of glaucoma revolves around the destruction of the optic nerve through the biomechanical forces of IOP being applied to the lamina cribrosa. The lamina cribrosa is a mesh-like network of collagen fibers located at the optic nerve head and forms a barrier between the vitreous humor and the retrobulbar space behind the eye(5). Unmyelinated retinal ganglion cell axons pass through the lamina cribrosa, and then are myelinated in the retrobulbar space forming the optic nerve bundle.…”

Section: Competing Theories Of Molecular Underpinnings Of Glaucomamentioning

confidence: 99%

Primary Open-Angle Glaucoma Genetics in African Americans

Restrepo

Bailey

2017

Curr Genet Med Rep

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Purpose of review Individuals of African descent are at highest risk for developing primary open-angle glaucoma (POAG), a devastating disease and major contributor of blindness worldwide. Currently, there is a large dearth of knowledge in this area despite a critical need for better understanding the underlying genetic and environmental factors afflicting this population. Here we highlight the current literature exploring the genetics of POAG in African Americans. Recent findings Current studies have yet to replicate European POAG index variants (i.e. CDKN2B-AS1 and SIX1/SIX6) in African Americans or to definitely exclude that these loci contribute to risk in African descent populations. Recent studies have evaluated clinical features that may account for some differences in POAG risk between African Americans and European Americans. Summary In summary, little headway has been made in elucidating the genetics of primary open-angle glaucoma in African Americans and other individuals of African descent.

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Three dimensional analysis of the lamina cribrosa in glaucoma

Abstract: A new parameter quantifying depth variations in the cup floor significantly discriminated between groups of normal and glaucoma patients. This new parameter may contribute to a better understanding of the pathogenesis of the glaucomatous optic nerve damage in different types of glaucoma.

Cited by 31 publications

References 17 publications

Corneal Hysteresis and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma

Corneal Hysteresis and Progressive Retinal Nerve Fiber Layer Loss in Glaucoma

Adaptive optics optical coherence tomography in glaucoma

Primary Open-Angle Glaucoma Genetics in African Americans

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