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Stephanie Zwillinger, Michel Paques, Betty Safran, Christophe Baudouin; In vivo characterization of lamina cribrosa pores in primary open-angle glaucoma families.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1000.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the heritability of the morphology of lamina cribrosa (LC) pores in primary open angle glaucoma patients and their relatives.
Cross-sectional, observational study. Adaptive optics (AO) images (rtx1, ImagineEye, France) of the optic disc was performed in 30 patients with primary open angle glaucoma (POAG), 14 of direct relatives with no sign of glaucomatous neuropathy and 29 controls. Two masked graders measured each visible pore along the major and minor axes of the LC in order to categorize pores as oval or round (oval if smallest over largest width <0.75). The Kappa coefficient was calculated to ensure inter-observer coherence.
LC pores were visible in 69 out of 73 subjects. In glaucomatous patients, 79% of visible pores were classified as oval versus 32.2% in controls (p<0.001). Average pore surface area was also significantly larger in glaucoma subjects (1,555px² versus 751px²; p<0.001). Of the 14 relatives, 5 had more than 60% of pores classified as oval with an average surface of 1,196px². The average surface area of LC pores in the other 9 subjects was 724px² and less than 30% of pores were classified as oval.
Wether lamina cribrosa changes are risk factors for or consequences of glaucomatous neuropathy remains a critical challenge for forthcoming research. Our data showing that nonglaucomatous subjects from POAG families may show LC pore changes similar to their affected relatives support the hypothesis that LC changes precede neuronal loss.
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