June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Prelaminar and Lamina Cribrosa Defects Detected by Swept Source OCT in Glaucoma Stratified by Visual Field Loss Pattern
Author Affiliations & Notes
  • Elise Taniguchi
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Eleftherios I Paschalis
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Dejiao Li
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Haobing Wang
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
    Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Stacey C. Brauner
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Scott H. Greenstein
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Angela V. Turalba
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Louis R Pasquale
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Lucy Q Shen
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Footnotes
    Commercial Relationships Elise Taniguchi, None; Eleftherios Paschalis, None; Dejiao Li, None; Haobing Wang, None; Stacey Brauner, None; Scott Greenstein, None; Angela Turalba, None; Louis Pasquale, None; Lucy Shen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2056. doi:
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    • Get Citation

      Elise Taniguchi, Eleftherios I Paschalis, Dejiao Li, Haobing Wang, Stacey C. Brauner, Scott H. Greenstein, Angela V. Turalba, Louis R Pasquale, Lucy Q Shen; Prelaminar and Lamina Cribrosa Defects Detected by Swept Source OCT in Glaucoma Stratified by Visual Field Loss Pattern. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2056.

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

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Abstract
 
Purpose
 

To evaluate quantitative and qualitative prelaminar and lamina cribrosa defects, in healthy eyes and in open angle glaucoma (OAG) eyes, stratified by patterns of Humphrey visual field (HVF) loss.

 
Methods
 

Twenty-six OAG patients, with visual acuity better than 20/50, and no previous glaucoma surgeries were recruited to this study, along with seven age-matched healthy subjects. All participants underwent volume and radial scans of the optic nerve head by swept source optical coherence tomography (SS-OCT, Atlantis, Topcon). Two masked observers (LQS, EVT) reviewed all OCT images and identified prelaminar and lamina cribrosa defects. Qualitative prelaminar defects were classified into lacuna and wedge defects. Qualitative laminar defects comprised holes and disinsertions. Quantitative parameters, such as minimum rim width at Bruch’s membrane opening (BMO-MRW), vertical lamina cribrosa depth (LCD) and horizontal LCD, were measured using customized ImageJ plugins. HVF was classified into 3 categories based on objective criteria: isolated paracentral defect, isolated peripheral defect and combined paracentral-peripheral damage. Only one eye per patient was analyzed. One-way analysis of variance and independent t-test were used for group comparison.

 
Results
 

The presence of wedge prelaminar defects among eyes with isolated paracentral defect on HVF was significant higher than among healthy eyes (50.0% vs. 0.0%; p=0.025) (Table). In addition, BMO-MRW in eyes with isolated paracentral defect was significantly lower than in eyes with early peripheral defect (p=0.016) and healthy eyes (p= 0.001). Eyes with combined paracentral-peripheral damage on HVF presented with significantly more lacunae in the prelaminar tissue than controls (83.3% vs. 14.3%; p=0.010). However, no statistically significant difference was found in the presence of laminar defects among controls (14.3%), isolated paracentral defect (40%), isolated peripheral defect (10%) and combined paracentral-peripheral damage (33.3%)(p>0.05). Likewise, neither vertical nor horizontal LCD was statistically different among the groups.

 
Conclusions
 

While larger sample sizes are needed, SS-OCT demonstrates that prelaminar pathology, as opposed to laminar pathology, predominates in eyes with OAG. Wedge prelaminar defect and lower BMO-MRW may be a SS-OCT structural biomarker for paracentral visual loss in OAG.  

 
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