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Kohei Takayama, Masanori Hangai, Yugo Kimura, Satoshi Morooka, Masayuki Nukada, Tadamichi Akagi, Atsushi Nonaka, Hanako O. Ikeda, Akiko Matsumoto, Nagahisa Yoshimura; Abnormal Lesions Of The Lamina Cribrosa In Eyes With Glaucoma Visualized Using Swept-source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2816.
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To determine whether the pathologic changes associated with the lamina cribrosa can be detected in eyes with glaucoma using swept-source optical coherence tomography (SS-OCT).
In total, 210 eyes of 135 patients with glaucoma were included. All the subjects were examined using an SS-OCT prototype system (TOPCON), which employs a tunable laser as a light source and operated at 100,000 Hz A-scan repetition rate in the 1-μm wavelength region. The speckle noise-reduced vertical and horizontal B-scan images were produced by averaging 50 B-scans. Three-dimensional volumetric measurement comprising 256 × 256 A-scans was acquired in 0.8 seconds over a square area of 3 mm x 3 mm centered on the optic disc. Volume rendering was performed in order to reconstruct the 3D image from the 3D data set. En face images of the 3D image and vertical and horizontal B-scan images were used to observe the lamina structures.
SS-OCT imaging enabled improved visualization of the whole lamina cribrosa as a highly reflective plate, including the areas beneath the neuroretinal rim and at the posterior portion of the lamina cribrosa. The en face images enabled visualization of the laminar pores in the whole lamina area, including those beneath the neuroretinal rim. We observed a unique abnormal lesion, split of the lamina plate, in 10 (4.8%) of 210 eyes. Non-reflective spaces, like caves, at all levels of the highly reflective plate were identified in these eyes. In 4 of the 10 eyes, the abnormal lesions were spatially associated with concurrent and previous disc hemorrhages. No history of disc hemorrhage was observed in the other 6 eyes. Correlation between the split of the lamina plate and disc hemorrhage was noted. (P = 0.027, chi-square test)
Thus, SS-OCT imaging is effective for visualization of the whole lamina structure and abnormal lesions in eyes with glaucoma. Defects may be present within the lamina cribrosa of a part of the eyes affected with glaucoma.
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