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Syril Dorairaj, Sung C. Park, Saman Kiumehr, Christopher C. Teng, Celso Tello, Jeffrey M. Liebmann, Robert Ritch; Inter-Eye Comparison of the Morphology and Position of the Lamina Cribrosa in Subjects with Unilateral Glaucomatous Visual Field Loss. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5091.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the morphology and position of the lamina cribrosa (LC) between the eyes of subjects with unilateral glaucomatous visual field (VF) loss using enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT).
Serial horizontal and vertical B-scans of the optic nerve head were obtained using EDI SD-OCT for both eyes of each subject with a unilateral, advanced glaucomatous VF defect (mean deviation [MD] worse than -12 dB by standard automated perimetry). Subjects with a HRT-measured disc area difference between the two eyes >0.3 mm2 were excluded. Mean and maximum LC depths were measured in 11 equally spaced horizontal B-scans, and the depth of the LC insertion was measured at 32 points along its circumference (reference plane: Bruch’s membrane edges) (Fig A,B). Depth profiles of the LC and LC insertion were compared between the VF defect eye (VFDE) and the fellow eye (FE) before and after controlling for the vertical diameter of LC and the angle of optic nerve tilting, which have been suggested to have a significant negative correlation with LC depth.
A total of 21 subjects were included (MD: -18.9±3.9 dB [VFDE] and -2.2±1.1 dB [FE]). Before and after controlling for the vertical diameter of LC and the angle of optic nerve tilting, mean and maximum LC depths were significantly greater in the VFDE than in the FE (posterior bowing, Fig C). The depth of the LC insertion was significantly greater in the VFDE than in the FE in the superior and inferior regions (posterior sliding of LC insertion, Fig D). There were 2 (9.5%) patients with greater depths of the LC and LC insertion in the FE than in the VFDE.
In eyes with advanced glaucomatous VF loss, the LC undergoes posterior bowing and the LC insertion undergoes posterior sliding compared to the FE with a normal visual field.
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