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Yugo Kimura, Masanori Hangai, Tadamichi Akagi, Munemitsu Yoshikawa, Hiroshi Yamada, Tomoko Hasegawa, Kenji Suda, Hanako Ohashi Ikeda, Nagahisa Yoshimura; Association between focal lamina cribrosa defects and the parameters of optic disc deformation in glaucomatous eyes with high myopia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):899.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether focal lamina cribrosa (LC) defects are associated with the optic disc deformation in glaucomatous eyes with high myopia
Three-dimensional images of the optic disc obtained using swept-source optical coherence tomography (SS-OCT) and 6 raster scan images centered at the optic disc by using spectral domain OCT (Spectralis-OCT) were used to evaluate the presence of focal LC defects and Bruch membrane (BM) opening and retinal pigment epithelium (RPE) beginning, respectively. Disc border was determined using infrared images, which automatically corresponded with the raster scan image. The lengths of peripapillary atrophy (PPA) with and without BM were manually measured in each raster scan, and their location was classified into temporal, nasal, superior, and inferior sectors. The tilt angle, which was defined as the angle between the lines connecting both sides of BM opening and both sides of disc border, was measured in the same raster scan images, and the horizontal and vertical tilt angles were examined.
Mean age, spherical equivalent, and mean deviation in Humphrey automated perimetry, respectively, were 49.5 years, -8.4 diopters, and -10.8 dB in 129 glaucomatous eyes with high myopia (< -6 diopters), and 49.4 years, -9.5 diopters, and -1.4 dB in 43 age-matched control subjects with high myopia. Focal LC defects were detected in 70 of the 129 eyes (54.2%) in glaucomatous eyes, which were defined as the LCD(+) group, and no LC defects were detected in the controls. In temporal sector, PPA length without BM was significantly longer in the LCD(+) group (578±338 µm) than in the LCD(-) group (340±316 µm) and control subjects (402±269 µm)(P < 0.001). PPA length with BM in the temporal sector was not different among the 3 groups. In the nasal, superior, and inferior sectors, PPA length with and without BM was not different among the 3 groups. Horizontal and vertical tilt angles were significantly larger in the LCD(+) group (3.8±3.6° and 9.7±5.7°) than in the LCD(-) group (1.8±2.1° and 5.6±4.7°) and controls (2.3±3.3° and 6.3±5.9°)( P < 0.001 in both).
The glaucomatous eyes with focal LC defects had longer temporal PPA length without BM and larger tilt angle. Formation of focal LC defects is associated with disc deformation in glaucomatous eyes with high myopia.
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