June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Lamina Cribrosa Position and Superior Visual Field Loss in Glaucoma
Author Affiliations & Notes
  • Yiyi Liu
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    New York Medical College, Valhalla, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthamology, New York Medical College, Valhalla, NY
  • Rafael Furlanetto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Camila Netto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Uma Damle
    Robert Wood Johnson Medical School, New Brunswick, NJ
  • Jeffrey Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthamology, New York University School of Medicine, New York, NY
  • Robert Ritch
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthamology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Yiyi Liu, None; Sung Chul Park, None; Rafael Furlanetto, None; Camila Netto, None; Uma Damle, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Allergan, Inc. (F), Carl Zeiss Meditech, Inc (F), Heidelberg Engineering, GmbH (F), Topcon Medical Systems, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (F), SOLX, Inc. (C), Bausch & Lomb, Inc (C), Diopsys, Inc. (C), Diopsys, Inc. (F), Merz, Inc. (C), Glaukos, Inc. (C), Quark, Inc. (C); Robert Ritch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2246. doi:
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      Yiyi Liu, Sung Chul Park, Rafael Furlanetto, Camila Netto, Uma Damle, Jeffrey Liebmann, Robert Ritch, ; Lamina Cribrosa Position and Superior Visual Field Loss in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2246.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare the position of the lamina cribrosa (LC) in glaucomatous eyes with superior hemifield visual field defects (VFD) with its position in normal eyes, to see if posterior LC displacement occurs in association with VFD.

 
Methods
 

Normal subjects and glaucoma patients with VFD limited to the superior hemifield were recruited. All participants had a complete ophthalmologic examination including standard automated perimetry and retinal nerve fiber layer (RNFL) thickness measurement using optical coherence tomography (OCT). Serial horizontal enhanced depth imaging (EDI) OCT B-scans of the optic nerve head were obtained from each participant (interval between scans = ~30 μm). After delineating the anterior LC surface, mean and maximum LC depths (reference plane, Bruch’s membrane edges) were measured in 11 equally spaced horizontal B-scans, excluding the LC insertion area under Bruch’s membrane and the scleral rim (Fig A and B). Mean and maximum LC depths in each of the 11 B-scans were compared between the 2 groups.

 
Results
 

57 normal eyes (57 subjects; mean age = 56±18 years) and 35 glaucomatous eyes with only superior VFD (35 patients; mean age = 59±17 years; VF mean deviation = -5.9±4.0 dB) were included. The RNFL was significantly thinner in the glaucomatous eyes in both the inferior (59 vs. 95 µm; p<0.01) and in the superior retina (81 vs. 98 µm; p<0.01) compared to the normal eyes. Both mean and maximum LC depths were significantly greater in the glaucomatous eyes in all 11 scans (all p<0.01; Fig C and D). Posterior LC displacement in the glaucomatous eyes appeared to be similar between the superior and inferior LC.

 
Conclusions
 

We found generalized posterior displacement of the entire central and mid-peripheral LC in the glaucomatous eyes with VFD limited to the superior hemifield, suggesting that detectable LC displacement occurs early in human glaucoma prior to the development of VFD. Studies are needed to elucidate the causal and temporal relationships of peripheral LC deformation with glaucomatous VFD.

 
 
(A) White dots = Bruch’s membrane edges; black dots = anterior laminar insertion points; maximum lamina cribrosa (LC) depth = black double arrow; mean LC depth = (area S / length D). (B) The circle indicates the LC. (C and D) Mean and maximum LC depth profiles in the normal and the glaucoma groups.
 
(A) White dots = Bruch’s membrane edges; black dots = anterior laminar insertion points; maximum lamina cribrosa (LC) depth = black double arrow; mean LC depth = (area S / length D). (B) The circle indicates the LC. (C and D) Mean and maximum LC depth profiles in the normal and the glaucoma groups.
 
Keywords: 577 lamina cribrosa • 550 imaging/image analysis: clinical • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  
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