June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Posterior Lamina Cribrosa Displacement at Different Stages of Glaucoma
Author Affiliations & Notes
  • 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
  • Rafael Furlanetto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Camila Netto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, 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, New York, NY
  • Yungtai Kung
    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, New York, NY
  • Sandra Fernando-Sieminski
    Ross Eye Institute, State University of New York at Buffalo, Buffalo, 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 Sung Chul Park, None; Rafael Furlanetto, None; Camila Netto, None; Yiyi Liu, None; Yungtai Kung, None; Sandra Fernando-Sieminski, 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, 5917. doi:
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      Sung Chul Park, Rafael Furlanetto, Camila Netto, Yiyi Liu, Yungtai Kung, Sandra Fernando-Sieminski, Jeffrey Liebmann, Robert Ritch; Posterior Lamina Cribrosa Displacement at Different Stages of Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5917.

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

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Abstract
 
Purpose
 

To compare in vivo lamina cribrosa (LC) position between normal subjects and patients with glaucoma at different stages.

 
Methods
 

Normal subjects and glaucoma patients at various disease stages were recruited. All participants had a complete ophthalmologic examination including standard automated perimetry (SAP; 24-2 SITA-standard, Humphrey Field Analyzer). Serial horizontal enhanced depth imaging optical coherence tomography (EDI OCT) B-scans of the optic nerve head were obtained from each participant (interval between scans, ~30 μm). After delineating the anterior LC surface, mean LC depth (reference plane, Bruch’s membrane edges) was measured in 11 equally spaced horizontal B-scans for one eye of each participant, excluding the LC insertion area under Bruch’s membrane and the scleral rim (Fig A and B). Mean LC depth was compared among 1) normal eyes, 2) glaucomatous eyes with no visual field defects (VFD) (pre-perimetric glaucoma), and 3) glaucomatous eyes with VFD. Age, intraocular pressure (IOP) and angle of lateral LC displacement (Fig C) were recorded.

 
Results
 

62 normal eyes (mean age, 55±17 years), 43 pre-perimetric glaucoma eyes (mean age, 61±17 years), 104 glaucomatous eyes with VFD (mean age, 59±17 years; mean VF mean deviation [MD], -12.9±8.2 dB) were included. Mean LC depth was significantly different among the glaucoma with VFD, pre-perimetric glaucoma, and normal groups (434±102, 395±74, and 351±70 µm, respectively), before and after controlling for age, IOP and angle of lateral LC displacement (all p<0.03). Mean LC depth was significantly greater in the same order in all 11 scans after controlling for age, IOP and angle of lateral LC displacement (all p<0.04; Fig D). Among glaucomatous eyes with VFD, mean LC depth had no significant correlation with VF MD (p=0.14; Fig E).

 
Conclusions
 

In human glaucoma, posterior displacement of the central and mid-peripheral LC occurs mostly at earlier stages of glaucoma before the development of VFD detectable in SAP.

 
 
(A) White dots = Bruch’s membrane edges; black dots = anterior LC insertion points; mean LC depth = (area S/length D). (B) The circle indicates the LC. (C) Angle of lateral LC displacement (θ) was measured in the horizontal midline scan of the LC. Blue dot = midpoint between the 2 Bruch’s membrane edges. Red dot = midpoint between the 2 anterior LC insertion points. (D) Mean LC depth profiles. (E) Scatterplot of mean LC depth vs. VF MD.
 
(A) White dots = Bruch’s membrane edges; black dots = anterior LC insertion points; mean LC depth = (area S/length D). (B) The circle indicates the LC. (C) Angle of lateral LC displacement (θ) was measured in the horizontal midline scan of the LC. Blue dot = midpoint between the 2 Bruch’s membrane edges. Red dot = midpoint between the 2 anterior LC insertion points. (D) Mean LC depth profiles. (E) Scatterplot of mean LC depth vs. VF MD.
 
Keywords: 577 lamina cribrosa • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 550 imaging/image analysis: clinical  
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