March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Laminar and Prelaminar Tissue Displacement after Glaucoma Surgery Imaged with Spectral Domain Optical Coherence Tomography
Author Affiliations & Notes
  • Alexandre S. Reis
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
    Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil
  • Neil O'Leary
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Miriam Stanfield
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Krista Butts
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Lesya Shuba
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Marcelo T. Nicolela
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Balwantray C. Chauhan
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Footnotes
    Commercial Relationships  Alexandre S. Reis, None; Neil O'Leary, None; Miriam Stanfield, None; Krista Butts, None; Lesya Shuba, None; Marcelo T. Nicolela, None; Balwantray C. Chauhan, Heidelberg Engineering (S)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3691. doi:
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      Alexandre S. Reis, Neil O'Leary, Miriam Stanfield, Krista Butts, Lesya Shuba, Marcelo T. Nicolela, Balwantray C. Chauhan; Laminar and Prelaminar Tissue Displacement after Glaucoma Surgery Imaged with Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3691.

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

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Abstract
 
Purpose:
 

To determine the response of the lamina cribrosa and prelaminar tissue, imaged and quantified with spectral domain OCT (SD-OCT), in glaucoma patients after trabeculectomy.

 
Methods:
 

Twenty-two patients (median [range] age 73.4 [47 to 88] y) undergoing trabeculectomy had one eye imaged with SD-OCT to obtain 24 high-resolution radial B-scans centered on the optic nerve head (ONH). Co-localized images were acquired 1 week, 1, 3 and 6 months after surgery. Bruch’s membrane opening (BMO), the internal limiting membrane (ILM) and the anterior lamina surface (ALS) were delineated in each B-scan using custom software. Surfaces were fitted to the ILM and ALS with the extracted 3D coordinates. Localized changes in ILM and ALS were measured over time relative to a reference plane fitted to BMO. The average localized change determined laminar displacement (LD) and prelaminar tissue displacement (PTD) with positive values indicating anterior movement.

 
Results:
 

Mean (SD) intraocular pressure (IOP) at baseline was 18.1 (6.5) mmHg, which was reduced by 4.6 (5.1), 4.0 (8.0), 6.4 (7.0) and 7.0 (9.0) mmHg at 1 week, 1, 3 and 6 months, respectively. There was significant mean anterior PTD (P<0.001) and LD (P=0.003) over time (Figure). Mean (SD) PTD (4.0 [12.4] µm, 3.4 [9.7], 24.4 [25.1] and 27.1 [27.2]) was statistically different from zero at 3 and 6 months (P<0.001) while LD (1.7 [9.2] µm, -1.6 [9.2], 7.6 [20.2] and 18.7 [27.7]) only at 6 months (P=0.01). The mean PTD was greater than LD (P<0.001).

 
Conclusions:
 

The ALS is less compliant than prelaminar tissue to IOP decrease after glaucoma surgery. Prelaminar tissue displacement is more representative of ONH surface changes than laminar displacement after glaucoma surgery, and these changes tend to persist at least up to 6 months.  

 
Keywords: imaging/image analysis: clinical • intraocular pressure • optic nerve 
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