April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Anterior Laminar Cribrosa Surface Depth as a Diagnostic Parameter for Glaucoma
Author Affiliations & Notes
  • Mugen Liu
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Yiyi Liu
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Jeffrey M Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, 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 of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Mugen Liu, None; Sung Chul Park, Heidelberg Engineering, GmbH (F), Heidelberg Engineering, GmbH (R); Yiyi Liu, None; Jeffrey Liebmann, Carl Zeiss Meditech, Inc. (C), Heidelberg Engineering, GmbH (C), Heidelberg Engineering, GmbH (F), New York Glaucoma Research Institute (F), Optovue, inc (F), Topcon, Inc. (F); Robert Ritch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4246. doi:
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    • Get Citation

      Mugen Liu, Sung Chul Park, Yiyi Liu, Jeffrey M Liebmann, Robert Ritch; Anterior Laminar Cribrosa Surface Depth as a Diagnostic Parameter for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4246.

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

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Abstract
 
Purpose
 

To investigate the diagnostic capability of the anterior lamina cribrosa surface depth (ALCSD) for glaucoma.

 
Methods
 

Normal subjects and glaucoma patients at various disease stages were recruited. Each participant had a complete ophthalmologic examination including standard automated perimetry (SAP) and circumpapillary retinal nerve fiber layer (RNFL) imaging using spectral-domain 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 lamina cribrosa surface, ALCSD (reference plane, Bruch’s membrane edges) under the Bruch’s membrane opening (Fig 1A) was measured in 11 equally spaced horizontal B-scans and averaged to generate mean ALCSD for one eye of each participant. Receiver operating characteristic (ROC) curves were obtained for mean ALCSD and average RNFL thickness (RNFLT). Areas under the ROC curve (AUCs) and sensitivities at a fixed specificity (90%) were compared between mean ALCSD and average RNFLT.

 
Results
 

86 normal eyes (mean age, 56±14 years) and 162 glaucoma eyes (47 with pre-perimetric glaucoma, 55 with SAP mean deviation [MD] ≥-12 dB and 60 with SAP MD <-12 dB; mean age = 60±16, 59±16 and 59±17 years, respectively) were included. ALCSD showed a Gaussian distribution in normal eyes (p=0.08) and a skewed distribution in glaucoma eyes (p<0.001) (Fig 1B and 1C). Mean ALCSD was significantly greater in glaucoma than in normal eyes (429±98 µm vs. 355±66 µm, p<0.001). The AUC of ALCSD was 0.729 for all glaucoma eyes, 0.672 for pre-perimetric eyes, 0.792 for glaucoma eyes with MD ≥-12 dB, and 0.717 for eyes with MD <-12 dB (all p<0.001; Fig 2). For pre-perimetric glaucoma eyes, the AUC of ALCSD was comparable to that of RNFLT (p=0.17, Fig 2B); the sensitivities of ALCSD and RNFLT at a specificity of 90% were 34.0% and 38.3%, respectively. However, the AUC of ALCSD was significantly smaller than that of RNFLT for glaucoma eyes with SAP MD either ≥ or <-12 dB (both p<0.001, Fig 2C and 2D); the sensitivities of ALCSD and RNFLT at a specificity of 90% were 50.9% and 84.8% for eyes with MD ≥-12 dB and 46.7% and 100% for eyes with MD <-12 dB, respectively.

 
Conclusions
 

Diagnostic capability of ALCSD was comparable to that of RNFLT in pre-perimetric glaucoma. In glaucoma eyes with SAP visual field loss, RNFLT had better diagnostic value than ALCSD.

     
Keywords: 577 lamina cribrosa • 495 depth • 550 imaging/image analysis: clinical  
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