June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Spatial Relationship between Bruch’s Membrane Opening and Lamina Cribrosa Determines Optic Disc Tilting
Author Affiliations & Notes
  • Pat-Michael Palmiero
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Yiyi Liu
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    New York Medical College, Valhalla, NY
  • Camila Netto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Rafael Furlanetto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Mohammed Al-Jumayli
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Jeffrey Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York University School of Medicine, New York, NY
  • Robert Ritch
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Pat-Michael Palmiero, None; Sung Chul Park, None; Yiyi Liu, None; Camila Netto, None; Rafael Furlanetto, None; Mohammed Al-Jumayli, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Allergan, Inc. (F), Carl Zeiss Meditech, Inc (F), Heidelberg Engineering, GmbH (F), Topcon Medical Systems, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (F), SOLX, Inc. (C), Bausch & Lomb, Inc (C), Diopsys, Inc. (C), Diopsys, Inc. (F), Merz, Inc. (C), Glaukos, Inc. (C), Quark, Inc. (C); Robert Ritch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3032. doi:https://doi.org/
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      Pat-Michael Palmiero, Sung Chul Park, Yiyi Liu, Camila Netto, Rafael Furlanetto, Mohammed Al-Jumayli, Jeffrey Liebmann, Robert Ritch; Spatial Relationship between Bruch’s Membrane Opening and Lamina Cribrosa Determines Optic Disc Tilting. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3032. doi: https://doi.org/.

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

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Abstract
 
Purpose
 

To investigate the association between tilted disc geometry and location of the lamina cribrosa (LC) relative to Bruch’s membrane opening (BMO).

 
Methods
 

Normal subjects with axial length less than 26.5 mm were recruited. Serial horizontal and vertical enhanced depth imaging optical coherence tomography (EDI OCT) B-scans of the optic nerve head (interval between scans, ~30 μm) were obtained for one eye of normal subjects. After reconstructing a 3-dimensional image of BMO and the anterior LC insertion points, the distance between the centroids of BMO and the LC was measured (Fig A). The direction of lateral LC displacement from BMO was measured as an angle (θ1) between the line connecting the two centroids and temporal horizontal line (Fig B). Disc ovality index (longest disc diameter/shortest disc diameter) was measured using infrared disc photographs. The direction of disc tilting was measured as an angle (θ2) between the axis of shortest disc diameter and the temporal horizontal line (Fig C).

 
Results
 

23 normal eyes (23 subjects) were included (mean age, 42±15 years). Mean distance between the centroids of BMO and the LC was 222±93 (range, 70 to 368) µm. Mean disc ovality index was 1.14±0.08 (range: 1.00 to 1.28) mm. The distance between the two centroids was significantly correlated with the disc ovality index (p<0.001, R=0.739; Fig D). The direction of lateral LC displacement from BMO (θ1) was also significantly correlated with the direction of disc tilting (θ2) (p<0.001, R=0.896; Fig E).

 
Conclusions
 

Lateral displacement of the LC from BMO underlies optic disc tilting. The severity and direction of lateral LC displacement from BMO determines the severity and direction of optic disc tilting.

 
 
(A and B) Green and blue dotted circles = anterior lamina cribrosa (LC) insertion points and Bruch’ membrane opening (BMO), respectively. Green and blue dots = centroids of the LC and BMO, respectively. (A) Red double arrow = distance between the two centroids. (B) Angle θ1 = direction of lateral LC displacement from BMO. (C) Angle θ2 = direction of disc tilting; yellow dotted lines = longest and shortest disc diameters.
 
(A and B) Green and blue dotted circles = anterior lamina cribrosa (LC) insertion points and Bruch’ membrane opening (BMO), respectively. Green and blue dots = centroids of the LC and BMO, respectively. (A) Red double arrow = distance between the two centroids. (B) Angle θ1 = direction of lateral LC displacement from BMO. (C) Angle θ2 = direction of disc tilting; yellow dotted lines = longest and shortest disc diameters.
 
Keywords: 577 lamina cribrosa • 438 Bruch's membrane • 627 optic disc  
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