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Tin A Tun, Xiaofei Wang, Baskaran Mani, Monisha E Nongpiur, Ching-Yu Cheng, NIcholas Strouthidis, Tin Aung, Michael J A Girard; Effect of Age and Glaucoma on Anterior Peripapillary Sclera Shape. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2028.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of age and glaucoma on anterior peripapillary sclera (PPS) shape
One eye from 22 subjects with primary open angle glaucoma (POAG), 27 with primary angle closure glaucoma (PACG), 18 with ocular hypertension (OHT), and from 24 healthy controls (14 elderly and 10 young subjects) was randomly selected and the optic nerve head was imaged with optical coherence tomography (Spectralis, Heidelberg, Germany). To assess anterior PPS shape configuration, we measured the angle between a line parallel to the nasal anterior PPS boundary and one parallel to the temporal anterior PPS boundary (Figure 1). A negative value indicated that the shape of the anterior PPS followed an inverted v-shape configuration (peak pointing towards the vitreous); whereas a positive value indicated that it followed a v-shape configuration (peak pointing towards the orbital tissues). PPS angles were compared among the diagnostic groups and a linear regression model was used to evaluate the relationship between the PPS angle and age.
The PPS angle in young controls was on average -3.6±5.68 degrees and was significantly different from that in elderly controls (3.71±4.62 degrees, P=0.029), in POAG (6.27±5.18 degrees, P<0.001), OHT (6.78±6.05 degrees, P<0.001), and in PACG subjects (9.33±6.5 degrees, P<0.001). The PPS angle was also significantly different between eyes with PACG and elderly controls (mean difference -5.62 degrees, P=0.039). An increase in age was associated with a v-shaped PPS (0.54 degrees increase in PPS angle per 1-year increase in age, 95%CI 0.36, 0.72, P<0.001) in all cases, and (0.66 degrees increase in PPS angle per 1-year increase in age, 95%CI 0.42, 0.9, P<0.001) after excluding eyes with glaucoma.
The PPS followed a v-shape configuration that was more pronounced with increasing age and with glaucoma. A better understanding of PPS shape, in conjunction with lamina cribrosa shape, may be useful to improve glaucoma management.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Anterior peripapillary sclera shape of a young and elderly subject
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