Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
This PDF is available to Subscribers Only