Age-related changes in the thickness of the human lamina cribrosa

Kotecha, Aachal; Izadi, Shahrnaz; Jeffery, Glen

doi:10.1136/bjo.2006.100388

Cited by 77 publications

(52 citation statements)

References 21 publications

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“…Although several previous studies reported that healthy males have thicker LCs than do females, this finding was not of statistical significance. 6,30 The present study also showed that male eyes have greater LTs than do female eyes, a finding not of statistical significance. Gender-specific differences may be due to differences in anatomical characteristics of the optic nerve head between genders, with males having slightly larger optic discs.…”

Section: Discussioncontrasting

confidence: 75%

“…5 Previous in vitro studies have revealed that laminar thickness (LT) increases significantly with age in the normal human globe, and that LCs of glaucomatous eyes are significantly thinner than those of normal eyes. 6,7 As the LC is on the posterior surface of the optic nerve head, it has been difficult to study due to technical limitations. With the recently developed combination of enhanced-depth imaging (EDI) optical coherence tomography (OCT) (EDI-OCT), visualisation of deep optic nerve head structures has improved.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced Depth Imaging of Central Laminar Thickness in Optic Neuropathy: Comparison with Normal Eyes

Thitiwichienlert

Ishikawa

Asakawa

et al. 2015

Neuro-Ophthalmology

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The purpose of this study was to compare central laminar thickness (LT) among patients with glaucomatous optic neuropathy (GON), patients with non-GON, and normal subjects using enhanced-depth imaging optical coherence tomography (EDI-OCT). Enrolled were 57 patients (n = 64 eyes), including 30 women and 27 men. Three groups were identified: GON (n = 18 eyes), non-GON (n = 16 eyes), and control (n = 30 eyes). The GON group comprised eyes with primary open-angle glaucoma (POAG) (n = 9) and normal-tension glaucoma (NTG) (n = 9). The non-GON group comprised eyes with demyelinating optic neuritis (n = 9), anterior ischemic optic neuropathy (AION) (n = 2), compressive ON (n = 2), Leber hereditary ON (n = 2), and traumatic ON (n = 1). GON and non-GON groups were further divided into mild, moderate, and severe subgroups. Inclusion in the GON group was based on mean deviations (MDs) of visual fields; inclusion in the non-GON group was based on critical flicker frequency (CFF) responses. Intraclass correlation coefficients (ICCs) were used to verify reproducibility of measurements. LTs of GON and non-GON group eyes were thinner than those of control group eyes (p50.01); LTs of GON group eyes were thinner than those of non-GON group eyes (p = 0.01). LTs of severe GON subgroup eyes were thinner than those of moderate and mild GON subgroup eyes (p50.001; p = 0.024, respectively). LTs of severe non-GON subgroup eyes were thinner than those of mild non-GON subgroup eyes (p = 0.002). These results show that EDI-OCT is valuable for documenting structural abnormalities in optic neuropathy (ON).

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Enhanced Depth Imaging of Central Laminar Thickness in Optic Neuropathy: Comparison with Normal Eyes

Thitiwichienlert

Ishikawa

Asakawa

et al. 2015

Neuro-Ophthalmology

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“…The aged ONH is more likely to have stiff connective tissues [113][114][115][116][117][118][119][120][121][122][123][124][125] and a compromised blood supply 126,127 . However, age-related increases in laminar beam thickness 114,117,119,124,128 , laminar astrocyte basement membrane thickness 117,128 and laminar extracellular matrix (ECM) hardening 114,117,119,128 should not only increase laminar beam stiffness, but should also diminish nutrient diffusion from the laminar capillaries through the laminar ECM, across the astrocyte BMs, and into the adjacent axons (Figure 1).…”

Section: Onh Biomechanics Onh Aging and Age-related Optic Nerve Axonmentioning

confidence: 99%

“…However, age-related increases in laminar beam thickness 114,117,119,124,128 , laminar astrocyte basement membrane thickness 117,128 and laminar extracellular matrix (ECM) hardening 114,117,119,128 should not only increase laminar beam stiffness, but should also diminish nutrient diffusion from the laminar capillaries through the laminar ECM, across the astrocyte BMs, and into the adjacent axons (Figure 1). Thus, for a given magnitude of IOP insult, the aged ONH should demonstrate: 1) less deformation due to the presence of a stiffer lamina and peripapillary sclera; and 2) more pallor for a given amount of deformation because a) the aged ONH may be more susceptible to axon loss and b) pallor precedes deformation in the aged eye, while deformation precedes (or supersedes) pallor in the young eye.…”

Section: Onh Biomechanics Onh Aging and Age-related Optic Nerve Axonmentioning

confidence: 99%

“…Because aged connective tissues are most commonly stiffer than younger connective tissues [113][114][115][116][117][118][119][120][121][122][123][124][125] , age should be a reasonable surrogate for ONH connective tissue stiffness. Stiffer ONH connective tissues lead to a shallower form of cupping in both the young and old patient 21 .…”

Section: Connective Tissue Stiffness Underlies the Appearance And Behmentioning

confidence: 99%

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Premise and Prediction???How Optic Nerve Head Biomechanics Underlies the Susceptibility and Clinical Behavior of the Aged Optic Nerve Head

Burgoyne¹,

Downs²

2008

Journal of Glaucoma

194

169

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We propose that age-related alterations in optic nerve head (ONH) biomechanics underlie the clinical behavior and increased susceptibility of the aged ONH to glaucomatous damage. The literature which suggests that the aged ONH is more susceptible to glaucomatous damage at all levels of intraocular pressure is reviewed. The relevant biomechanics of the aged ONH are discussed and a biomechanical explanation for why, on average, the stiffened peripapillary scleral and lamina cribrosa connective tissues of the aged eye should lead to a shallow (senile sclerotic) form of cupping is proposed. A logic for why age-related axon loss and the optic neuropathy of glaucoma in the aged eye may overlap is discussed. Finally, we argue for a need to characterize all forms of clinical cupping into prelaminar and laminar components so as to add precision to the discussion of clinical cupping which does not currently exist. Such characterization may lead to the early detection of ONH axonal and connective tissue pathology in ocular hypertension and eventually aid in the assessment of etiology in all forms of optic neuropathy including those that may be purely age-related. The Susceptibility of the Aged Optic Nerve Head (ONH)A variety of data suggest that the ONH becomes more susceptible to progressive glaucomatous damage as it ages, though this concept remains unproven through direct experimentation, and may not be true for every aged eye. These data can be summarized as follows. First, in most [1][2][3][4][5] , but not all 6,7 , population based studies, intraocular pressure (IOP) either does not increase with age or if it does, the magnitude of increase is not likely to be clinically important. Thus, the fact that the prevalence of the neuropathy increases with age 8 is likely explained by a greater susceptibility to IOP and other non-IOP-related risk factors, rather than a higher prevalence of IOP elevation, with increasing age. Second, in an extensive review of the literature, we can find only a few reports of the onset and progression of normal tension glaucoma (NTG) in infants, children and young adults 9 . While we acknowledge that accurate NTG prevalence estimates require long-term telemetric characterization of untreated IOP and rigorous population based ONH and visual field examinations, all existing studies suggest that NTG is most commonly a disease of the elderly [10][11][12][13][14][15] in the young 9 . Third, age is an independent risk factor for both the prevalence 16 and progression of the neuropathy at all stages of damage [17][18][19] . The Clinical Behavior of the Aged ONHApart from the issue of ONH susceptibility, we predict that if all aspects of insult are equal (alterations in IOP, the volume flow of blood and nutrient transfer from the laminar capillary to the ONH astrocyte are all of the same magnitude, duration and fluctuation), the aged eye will demonstrate clinical cupping that is on average shallow and pale (at all stages of field loss) compared to the eye of a child or young adult. This clini...

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