Factors Affecting Plastic Lamina Cribrosa Displacement in Glaucoma Patients

Abstract

PURPOSE.To investigate factors associated with irreversible components of anterior lamina cribrosa (LC) depth in glaucoma patients. METHODS.A total of 141 glaucoma patients and 51 healthy control subjects were enrolled. The optic nerve head (ONH) was imaged using the enhanced depth imaging (EDI) modes of Spectralis optical coherence tomography (OCT). The depth of the LC was measured at the midhorizontal, superior, and inferior midperipheral regions of the ONH of each eye. Analyzed factors associated LC depth included age, axial length, intraocular pressure (IOP), disc size, central corneal thickness, average retinal nerve fiber layer (RNFL) thickness, and mean deviation (MD). RESULTS.In glaucoma patients, the LC was more deeply located compared with the control group at the midhorizontal and superior and inferior midperipheral B-scans (All P < 0.001). Age, initial IOP, and treated IOP was correlated with mean LC depth (All P < 0.001), and those correlations remained after adjusting for MD and RNFL thickness (All P < 0.001). In multivariate analysis, younger age, high untreated IOP, and thinner RNFL thickness was significantly associated with a deeper LC (P ¼ 0.015, <0.001, and 0.042). There was an interaction between age and MD as predictors for LC depth (P ¼ 0.007).CONCLUSIONS. The anterior LC surface is more deeply located in glaucoma patients compared with healthy controls. In glaucoma patients, age, initial IOP, and RNFL thickness were influential factors related to LC depth. These factors should be considered in clinical application of plastic LC displacement in glaucoma patients.

Ocular characteristics associated with the location of focal lamina cribrosa defects in open-angle glaucoma patients

“…[34][35][36] We also found that LC depth was correlated with initially untreated IOP in our previous study. 37 IOP reduction reverses the posterior displacement of the LC. 4,38,39 Optic disc morphological characteristics of the eyes without a focal LC defect included generalized rim enlargement, which may also be related to the deep LC depth from a high IOP.…”

A Global Shape Index to Characterize Anterior Lamina Cribrosa Morphology and Its Determinants in Healthy Indian Eyes

“…4 In particular, glaucomatous onset is associated with posterior displacement of the anterior LC surface, 5-7 posterior migration of the LC insertion points, 6 and backward bowing of the entire LC. 8 Nonhuman primate models of glaucoma have also shown similar associations.…”

Prelamina and Lamina Cribrosa in Glaucoma Patients With Unilateral Visual Field Loss

“…Previous studies on the association between age and LC parameters have included large numbers of patients with high tension glaucoma or ocular hypertension. 36,38 By contrast, Rho et al 39 found no significant correlation between age and LCD in a group of normal tension glaucoma patients. The majority (36 of 41) of the glaucoma patients in the present study, moreover, were POAG patients with untreated IOP 21 mm Hg.…”

“…Acute IOP elevation was positively associated with prelaminar tissue displacement but not with laminar displacement in an experimental in vivo study of glaucoma patients and healthy controls. Jung et al, 36 after demonstrating a positive correlation between initial IOP and LCD (r ¼ 0391, P < 0.001) in glaucoma patients, suggested that initial IOP is the most decisive factor for LC displacement. Zhao et al, 37 in an animal study using cats, showed that as IOP increased, the thicknesses of both the LC and prelaminar tissue decreased and, further, that the thickness variation of the LC correlated significantly with the IOP increase when the IOP was higher than 60 mm Hg.…”

“…Jung et al 36 showed a negative correlation between age and anterior LCD, and Ren et al 38 demonstrated that agerelated difference increased with advancing disease severity. In the present study, however, no definite association between age and any of the anterior LC parameters (APLD, LCD, or PTT) was found in a total of 123 eyes when partial correlation analysis was applied to correct for MD.…”