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Sophie Cai, Marissa K. Shoji, Elise Taniguchi, Dejiao Li, Leonardo A. Pereira, Stacey C Brauner, Scott H. Greenstein, Angela Turalba, Louis R Pasquale, Lucy Shen; Swept-Source OCT Optic Nerve Head Structural Features of Primary Open Angle Glaucoma and Disc Hemorrhage. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
To identify localized differences in optic nerve head (ONH) structure imaged by swept-source optical coherence tomography (SS-OCT) in eyes with primary open angle glaucoma (POAG) and history of disc hemorrhage (DH), eyes with POAG but no DH history, and control eyes with no major non-cataract pathology.
POAG patients with history of inferotemporal DH, POAG patients with no DH history, and controls were recruited for this prospective, cross-sectional study. SS-OCT (Topcon) radial and 5-line cross ONH scans were performed. One eye per patient was included. Bruch’s membrane opening-minimum rim width (BMO-MRW) was measured from inferotemporal radial scans and compared across groups by ANOVA. Percentage frequencies of inferotemporal prelaminar and lamina cribrosa (LC) defects (Figure) identified by two masked observers were compared across groups by Fisher’s exact test. Multiple comparison post hoc tests were used to identify significant pairwise differences (P<0.05).
14 POAG patients with DH, 13 POAG patients without DH, and 12 controls were included. Patient groups were well matched by age, sex, and ethnicity (mean age 66.0±13.0 years, 35.9% male, and 100.0% Caucasian overall). Eyes with POAG with and without DH had similar Humphrey Visual Field mean deviations (mean -3.6±3.0 dB overall). Mean inferotemporal BMO-MRW differed significantly across groups (P<0.001), being thinner in eyes with POAG and DH (127.3±49.3 µm) and eyes with POAG but no DH (122.5±49.3 µm) than in controls (198.2±37.7 µm) (P=0.001; P<0.001) (Table). Prelaminar defect frequency differed significantly across groups (P=0.014). In subgroup analysis, specifically prelaminar hyporeflectivity frequency differed across groups (P=0.004), being higher in eyes with POAG and DH (57.1%) than in controls (0.0%; P=0.002). LC defect frequency differed across groups (P<0.001), being higher in eyes with POAG and DH (50.0%) than in eyes with POAG but no DH (0.0%) and also than in controls (0.0%) (P=0.006 for both).
SS-OCT enables identification of ONH structural features associated with POAG and specifically with DH. Compared to BMO-MRW and prelaminar defects, LC defects were specifically associated with DH. A longitudinal study is underway to further elucidate potential structural causes and consequences of DH.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Figure. Representative SS-OCT optic nerve head prelaminar and lamina cribrosa defects
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