Lamina cribrosa depth in different stages of glaucoma

Author(s): Park SC, Brumm J, Furlanetto RL, Netto C, Liu Y, Tello C, Liebmann JM, Ritch R

1 Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States Department of Ophthalmology, Hofstra North Shore-LIJ School of Medicine, Hampstead, New York, United States.
2 Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States.
3 Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States.

PURPOSE: To compare lamina cribrosa (LC) depth between normal eyes and eyes with different stages of treated glaucoma.

METHODS: Serial enhanced depth imaging (EDI) optical coherence tomography (OCT) B-scans of the optic nerve head were obtained. To generate the mean LC depth for each eye, LC depths were measured in 11 equally spaced horizontal B-scans and averaged. The mean LC depth was compared among normal, preperimetric, mild-to-moderate, and severe glaucoma groups. Among patients with visual field (VF) loss, correlation analysis was performed (1) between mean LC depth and VF mean deviation (MD), and (2) between mean LC depth and retinal nerve fiber layer (RNFL) thickness.

RESULTS: Eighty-six normal eyes (age, 56 ± 14 years), 47 preperimetric glaucoma eyes (age, 60 ± 16 years), 55 mild-to-moderate glaucoma eyes (age, 59 ± 16 years; VF MD, -6.0 ± 3.2 dB), and 60 severe glaucoma eyes (age, 59 ± 17 years; VF MD, -19.7 ± 6.1 dB) were included. Mean LC depth was significantly greater in preperimetric glaucoma than in normal eyes (390 vs. 344 μm, P = 0.004) and in mild-to-moderate than in preperimetric glaucoma eyes (448 vs. 390 μm, P = 0.001). However, no significant difference was observed between mild-to-moderate and severeglaucoma eyes (448 vs. 437 μm, P = 0.52). No correlation was observed between LC depth and VF MD (P = 0.56) or RNFL thickness (P = 0.90) in glaucomatous eyes with VF loss.

CONCLUSIONS: In treated glaucoma, posterior LC displacement occurs mostly in the preperimetric and mild-to-moderate glaucoma stages. This warrants further investigation of LC depth as a parameter to monitor glaucoma progression in the early stages.

Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

Invest Ophthalmol Vis Sci. 2015 Feb 26;56(3):2059-64. doi: 10.1167/iovs.14-15540.

PMID: 25722212
http://www.ncbi.nlm.nih.gov/pubmed/25722212

Keywords: glaucoma; lamina cribrosa; visual field

Clinical Paper of the Month manager: Andreas Boehm