April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
USING PRE-LAMINAR NEURAL TISSUE BASED INDICES FOR GLAUCOMA ASSESSMENT
Author Affiliations & Notes
  • Igor Rodrigo Lins da Silva
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Flavio Lopes
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Igor Matsubara
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Syril Dorairaj
    Mayo Clinic, Jacksonville, FL
  • Augusto Paranhos
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Roberto M Vessani
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Tiago S Prata
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Footnotes
    Commercial Relationships Igor Rodrigo Lins da Silva, None; Flavio Lopes, None; Igor Matsubara, None; Syril Dorairaj, None; Augusto Paranhos, None; Roberto Vessani, None; Tiago Prata, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 979. doi:https://doi.org/
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      Igor Rodrigo Lins da Silva, Flavio Lopes, Igor Matsubara, Syril Dorairaj, Augusto Paranhos, Roberto M Vessani, Tiago S Prata; USING PRE-LAMINAR NEURAL TISSUE BASED INDICES FOR GLAUCOMA ASSESSMENT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):979. doi: https://doi.org/.

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

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Abstract

Purpose: To use pre-laminar neural tissue thickness values obtained trough enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) to build new structural indices for glaucoma assessment

Methods: We prospectively enrolled glaucomatous patients, glaucomatous suspects, and healthy controls. Exclusion criteria were the presence of significant media opacity or any ocular disease besides glaucoma. All participants underwent EDI-OCT (SD-OCT; Spectralis®, Wavelength: 870nm; Heidelberg Engineering Co., Heidelberg, Germany) and visual field assessment using the Humphrey Visual Field Analyzer (24-2; SITA-Standard). The following optic nerve head (ONH) parameters were evaluated: lamina cribrosa and pre-laminar neural tissue thicknesses (PLNTT), scleral canal diameter (Bruch’s membrane opening), and cup depth. Two independent examiners assessed all EDI-OCT images (poor quality images were not included in the analysis). Three PLNTT based parameters [PLNTT to disc ratio (PLNTT/D), PLNTT to cup depth ratio (PLNTT/CD), and the PLNTT values itself] were compared among groups using analysis of covariance (accounting for age differences). Areas under receiver operating characteristic curves (AUCs) were calculated for each index and compared using the DeLong test. Whenever both eyes were eligible, one was randomly selected for analysis

Results: 25 eyes of 25 patients were included. Glaucomatous patients (including those from the suspect group) were significantly older than controls (p=0.01). Average visual field mean deviation of glaucomatous eyes was -4.5±3.6dB. The three indices differed significantly between glaucomatous patients and controls (p≤0.01); all indicating a significant pre-laminar neural tissue loss in glaucomatous eyes. In addition, the three indices showed good discrimination ability, with no significant differences between their AUCs (PLNTT/D, =0.87; PLNTT/CD, 0.84; PLNTT, 0.91; p≥0.18)

Conclusions: Using the EDI method to evaluate deep ONH structures in vivo, we found a significant reduction in pre-laminar neural tissue thickness in glaucomatous eyes. In this population with moderate glaucomatous damage, the three proposed indices showed good diagnostic performance. We believe these initial results deserve further evaluation, especially in a subset of patients with early functional damage

Keywords: 577 lamina cribrosa  
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