July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Optical Coherence Tomography (OCT) Anterior Scleral Canal Opening (ASCO) Tilt and Rotation relative to Bruch’s Membrane Opening (BMO) and Peripapillary Scleral Bowing (PSB) in Healthy Eyes
Author Affiliations & Notes
  • Ya Xing Wang
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
  • Hongli Yang
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Discoveries in Sight Research Laboratories, Devers Eye Institute, Oregon, United States
  • Haomin Luo
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Department of Ophthalmology, Second Xiangya Hospital, Hunan, China
  • Seung Woo Hong
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Department of Ophthalmology and Visual Sciences, Catholic University of Korea, Seoul, Korea (the Republic of)
  • Stuart Keith Gardiner
    Discoveries in Sight Research Laboratories, Devers Eye Institute, Oregon, United States
  • Jin Wook Jeoung
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Joseph Caprioli
    Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, California, United States
  • Shaban Demirel
    Discoveries in Sight Research Laboratories, Devers Eye Institute, Oregon, United States
  • Christopher A Girkin
    Department of Ophthalmology, University of Alabama at Birmingham, Alabama, United States
  • Jeffrey M Liebmann
    Department of Ophthalmology, Columbia University Medical Center, New York, United States
  • Christian Y Mardin
    Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen, Germany
  • Harry A Quigley
    Wilmer Eye Institute, Johns Hopkins University, Maryland, United States
  • Alexander F Scheuerle
    University Eye Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • Balwantray C Chauhan
    Department of Ophthalmology and Visual Sciences, Dalhousie University, Nova Scotia, Canada
  • Claude F Burgoyne
    Optic Nerve Head Research Lab, Devers Eye Institute, Oregon, United States
    Discoveries in Sight Research Laboratories, Devers Eye Institute, Oregon, United States
  • Footnotes
    Commercial Relationships   Ya Xing Wang, None; Hongli Yang, None; Haomin Luo, None; Seung Woo Hong, None; Stuart Gardiner, None; Jin Wook Jeoung, Allergan (C), PH Pharma (F), Santen (C); Joseph Caprioli, Heidelberg Engineering (F); Shaban Demirel, None; Christopher Girkin, Heidelberg Engineering (F); Jeffrey Liebmann, Aerie Pharmaceuticals, Inc (C), Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Bausch Lomb (C), Carl Zeiss Meditech, Inc. (C), FORSIGHT Vision5 (C), Heidelberg Engineering (C), Heidelberg Engineering (F), Heidelberg Engineering (S), Inotek Pharmaceuticals, Inc. (C), National Eye Institute (S), Quark Pharmacueticals, Inc. (C), Reichert, Inc. (C), Sustained Nano Systems (C); Christian Mardin, Heidelberg Engineering (F); Harry Quigley, Heidelberg Engineering (F); Alexander Scheuerle, Heidelberg Engineering (F); Balwantray Chauhan, Allergan (C), CenterVue (F), Heidelberg Engineering (C), Heidelberg Engineering (F), Heidelberg Engineering (S), Topcon (F); Claude Burgoyne, Heidelberg Engineering (C), Heidelberg Engineering (F), Heidelberg Engineering (S)
  • Footnotes
    Support  R01-EY02128, Legacy Good Samaritan Foundation, Heidelberg Engineering
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5516. doi:https://doi.org/
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      Ya Xing Wang, Hongli Yang, Haomin Luo, Seung Woo Hong, Stuart Keith Gardiner, Jin Wook Jeoung, Joseph Caprioli, Shaban Demirel, Christopher A Girkin, Jeffrey M Liebmann, Christian Y Mardin, Harry A Quigley, Alexander F Scheuerle, Balwantray C Chauhan, Claude F Burgoyne; Optical Coherence Tomography (OCT) Anterior Scleral Canal Opening (ASCO) Tilt and Rotation relative to Bruch’s Membrane Opening (BMO) and Peripapillary Scleral Bowing (PSB) in Healthy Eyes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5516. doi: https://doi.org/.

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

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Abstract

Purpose : To characterize OCT ASCO/BMO tilt, rotation and PSB in 362 healthy human eyes.

Methods : One eye of each subject underwent OCT imaging (Spectralis, 12° circle scan and 24 enhanced depth, ONH radial B scans), relative to the Fovea-BMO (FoBMO) axis. For each eye, BMO, ASCO and the peripapillary scleral surface were manually segmented and RNFL and MRW were computed. For BMO and ASCO, a long axis, centroid and fitted plane were determined. The neural canal (NC) axis was defined by the vector connecting BMO and ASCO centroids (Fig 1A). NC direction was determined by projecting the NC vector onto the BMO plane relative to the FoBMO axis. ASCO/BMO tilt magnitude was defined by the angle between the BMO and ASCO normal vectors. Its direction was determined by translating the ASCO normal vector to the BMO centroid and projecting it onto the BMO plane. ASCO/BMO rotation was determined by the angular displacement of the superior ASCO long axis relative to the superior BMO long axis (Nasal (+), Temporal (-)) (Fig 1B). PSB slope was calculated within each B-scan within a bilinear model of the scleral surface that provided inner (juxta-scleral canal) and outer slopes relative to a single inflection point (Fig 1C). Correlations between ocular, demographic, ASCO/BMO, PSB slope, RNFL and MRW parameters were assessed.

Results : Mean (range) ASCO/BMO tilt and rotation were 1.15±0.72° (0.04–4.97°) and 3.3±24.5° (-90–+84°), respectively. As tilt increased, its direction was more commonly nasal and more closely approximated the NC direction (P=0.001) (Fig 2A). In eyes with nasal ASCO tilt, a greater tilt angle correlated with increased inferior MRW (P=0.002, R2=0.16). Temporal ASCO rotation was associated with longer axial length, larger ASCO tilt, greater ASCO-BMO offset. Nasal ASCO rotation was associated with higher IOP and thicker RNFLT in the nasal and nasal-inferior sectors (all P<0.008) (Fig 2B). Sectoral PSB slopes were greatest inferior-temporally, increased with age, and age effects were greatest nasally (all P<0.001, GEE)), (Fig 2C).

Conclusions : Our study establishes OCT anatomic relationships between ASCO/BMO tilt, rotation, PSB and NC direction, which can be used to provide OCT–based guidelines for clinically evaluating optic disc tilt and torsion in healthy, myopic and glaucoma eyes.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

 

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