April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Clinical Optic Disc Findings Associated With Focal Lamina Cribrosa Defects in Glaucoma
Author Affiliations & Notes
  • Mohammed B Khalil
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye & Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye & Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Pengcheng Li
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye & Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Christopher C Teng
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye & Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Jeffrey M Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye & 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, New York Eye & Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Mohammed Khalil, None; Sung Chul Park, Heidelberg Engineering, GmbH (F), Heidelberg Engineering, GmbH (R); Pengcheng Li, None; Christopher Teng, None; Jeffrey Liebmann, Heidelberg Engineering, GmbH (C), Heidelberg Engineering, GmbH (F), National Institute of Health (F), New York Glaucoma Research Institute (F); Robert Ritch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 902. doi:
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    • Get Citation

      Mohammed B Khalil, Sung Chul Park, Pengcheng Li, Christopher C Teng, Jeffrey M Liebmann, Robert Ritch; Clinical Optic Disc Findings Associated With Focal Lamina Cribrosa Defects in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):902.

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

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Abstract
 
Purpose
 

To investigate the clinical optic disc findings associated with focal lamina cribrosa defects (FLCD) in glaucoma.

 
Methods
 

Serial enhanced depth imaging optical coherence tomography (EDI OCT) B-scans (interval between scans, ~30 μm) of the optic nerve head were obtained from glaucoma patients at various disease stages. EDI OCT scans were reviewed for presence/absence of focal LC defects (laminar holes or disinsertions) by a masked observer. The best quality stereo disc photo taken within 6 months from EDI OCT was selected for each eye by another masked observer. The disc photos were reviewed by another a third masked observer for presence/absence of a notch with remaining neuroretinal rim tissue, a notch with no remaining rim tissue, diffuse rim thinning, bayoneting of circumlinear vessel, beta-zone parapapillary atrophy (PPA), and acquired pit of the optic nerve (APON). Strength of association with the EDI OCT finding (presence/absence of FLCD) was calculated for each of the 6 clinical optic disc findings using Cramér's V test. Disc findings significantly associated with FLCD in Cramér's V test were entered into a multivariable logistic regression model. Disc hemorrhage was not included in the study because it would not be meaningful to include a transient finding such as disc hemorrhage in a cross-sectional analysis of irreversible findings.

 
Results
 

186 eyes of 186 glaucoma patients (mean age, 68±18 years) were included for analysis. A notch with no remaining rim tissue, diffuse rim thinning and APON were significantly correlated with FLCD (all p<0.02), but a notch with remaining rim tissue, beta-zone PPA and bayoneting of circumlinear vessels were not (all p>0.10) (Table 1). In the multivariable logistic regression model, a notch with no remaining rim tissue (p=0.001, odds ratio [OR]=3.47) and APON (p=0.004, OR=10.31) were significantly associated with FLCD. The association between diffuse rim thinning and FLCD was marginally significant (p=0.052 OR=2.26).

 
Conclusions
 

A notch with no remaining rim tissue was associated with FLCD, whereas a notch with remaining rim tissue was not. The association between APON and FLCD, previously reported by our group, was confirmed. These clinical optic disc features may be helpful in predicting the presence of FLCD and deciding EDI OCT-guided evaluation of the LC.

  
Keywords: 577 lamina cribrosa • 627 optic disc • 496 detection  
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