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Bo Wang, Ian A Sigal, Matthew A Smith, Tigran Kostanyan, Richard Anthony Bilonick, Huong Tran, Larry Kagemann, Elizabeth Tyler-Kabara, Joel S Schuman, Gadi Wollstein; In-vivo 3D Deformation of Lamina Cribrosa Microstructure in Response to Acute Changes in Intraocular and Cerebrospinal Fluid Pressures. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3979.
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© ARVO (1962-2015); The Authors (2016-present)
Deformation of the lamina cribrosa (LC) is thought to play a key role in the pathogenesis of glaucoma. Recent evidence implicates both intraocular pressure (IOP) and cerebrospinal fluid pressure (CSFP) in LC deformation. Therefore, we investigated the effects of acute in-vivo alterations in IOP and CSFP on 3D LC microstructure deformation.
In 3 macaque monkeys, we cannulated the anterior chamber of the eye and the lateral ventricle of the brain to control IOP and CSFP, respectively (Fig. 1A). OCT optic nerve head (ONH) imaging was performed under all combinations of IOPs (5, 15, 30 and 50mmHg) and CSFPs (5, 10, 25 and 40mmHg) conditions (Fig. 1B). For each eye, all scans were registered, and the same 3D LC region was analyzed for the following microstructure parameters: beam thickness, pore diameter and beam-pore ratio (ratio of beam thickness to pore diameter). A linear mixed effect model was used to determine the effect of translaminar pressure difference (TLPD = IOP - CSFP) and image quality (subjectively graded from 1 - 5) on LC microstructure.
LC microstructure deformation varied substantially between scans under the different pressure conditions (Fig. 1C). Accounting for the effect of image quality, all LC microstructure parameters were statistically significantly associated with TLPD: for every 10mmHg increase in TLPD, beam thickness decreased (-0.33±0.16μm, p<0.05), pore diameter increased (0.18±0.09μm, p<0.05), and beam-pore ratio decreased (-0.020±0.007, p<0.01).
TLPD is significantly associated with LC microstructural deformation that occurs during acute pressure modulation. These in-vivo findings emphasize the importance of considering both IOP and CSFP when evaluating the role of the LC in glaucoma pathogenesis.
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