Hemisphere opposite to central retinal vascular trunk deviation is earlier affected by glaucomatous damage in primary angle‐closure glaucoma

Oh, Richul; Lee, Kyoung Min; Kim, Martha; Oh, Sohee; Kim, Seok Hwan

doi:10.1111/aos.15258

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…The offset has been found to be larger in glaucomatous eyes than in fellow eyes in unilateral glaucoma 25 . Moreover, glaucomatous optic neuropathy occurrs more frequently 24 and earlier in the direction opposite to the offset 26 , 27 . In this paper, we suggest a new method for evaluation of asymmetric bulging that directly induces LC/BMO offset from the overgrowth part to the undergrowth part.…”

Section: Discussionmentioning

confidence: 95%

Association between eyeball asymmetry and offset of openings in optic nerve head canal assessed by posterior polar eyeball topography

Lee,

Rhim,

Ahn

et al. 2024

Sci Rep

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We investigated three-dimensional (3D) eyeball protrusion and its association with the offset between the lamina cribrosa (LC) and Bruch’s membrane opening (BMO). 3D-MRI scans were taken from 93 subjects (186 eyes). An ellipsoid was fitted along the posterior 2/3 contour of each eyeball. Eyeball asymmetry with focal bulging was determined by the existence of an adjacent outward protrusion/reciprocal inward depression pair, and the angular deviation of the outermost protruded point (OPP) was measured from the nasal side of the fovea-BMO axis. The LC/BMO offset was evaluated by measuring the central retinal vascular trunk (CRVT) location from the BMO center: (1) the angular deviation and (2) the offset index as the ratio between the CRVT-BMO center distance and the BMO radius in the same direction. Seventy-nine eyes (42%) were classified as having eyeball asymmetry, which had a more superior LC/BMO offset (P < 0.001) and a larger offset index (P = 0.002). In those eyes, the angular deviation of the OPP showed a significant correlation with that of the LC/BMO offset (r = -0.724, P < 0.001), as did protrusion depth with the offset index (r = 0.291, P = 0.009). The presence of eyeball asymmetry was associated with superior LC/BMO offset (P = 0.004) and larger offset index (P = 0.009). Superior LC/BMO offset was associated with older age (P < 0.001), shorter axial length (P < 0.001) and inferior location of OPP (P < 0.001). The location and extent of focal bulging were closely associated with those of LC/BMO offset. This indicates that focal bulging during expansion might be associated with diverse directionality of LC/BMO offset.

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Section: Discussionmentioning

confidence: 95%

Association between eyeball asymmetry and offset of openings in optic nerve head canal assessed by posterior polar eyeball topography

Lee,

Rhim,

Ahn

et al. 2024

Sci Rep

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Optic nerve head factors associated with initial central visual field defect in primary open-angle glaucoma

Bak,

Kim,

Kim

et al. 2024

Sci Rep

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We investigated optic nerve head factors associated with initial parafoveal scotoma (IPFS) in primary open-angle glaucoma. Eighty (80) patients with an IPFS and 84 patients with an initial nasal step (INS) were compared. Central retinal vascular trunk (CRVT) deviation from the Bruch’s membrane opening (BMO) center was measured as a surrogate of lamina cribrosa (LC)/BMO offset, and its obliqueness was defined as the absolute value of angular deviation from the fovea-BMO axis. Proximity of retinal nerve fiber layer defect (RNFLD) was defined as the angular deviation of the inner RNFLD margin from the fovea-BMO axis. Microvasculature dropout (MvD) was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the choroidal layer. Factors associated with IPFS, as compared with INS, were assessed using logistic regression analyses and conditional inference tree analysis. The IPFS group had more oblique CRVT offset (P < 0.001), RNFLD closer to the fovea (P < 0.001), more MvD (P < 0.001), and more LC defects (P < 0.001) compared to the INS group. In logistic regression analyses, obliqueness of CRVT offset (P = 0.002), RNFLD proximity (P < 0.001), and MvD (P = 0.001) were significant factors influencing the presence of IPFS. Conditional inference tree analysis showed that RNFLD closer to the fovea (P < 0.001) in the upper level, more oblique CRVT offset (P = 0.013) and presence of MvD (P = 0.001) in the lower level were associated with the probability of having IPFS. IPFS was associated with closer RNFLD location to the fovea when assessed from the BMO. Oblique LC/BMO offset may not only mask RNFLD proximity to the fovea due to a deviated funduscopic disc appearance, but also potentiate IPFS via focal LC defect and MvD.

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Structural Features of Optic Nerve Head in Glaucoma with Single-hemispheric and Bi-hemispheric Visual Field Defects

Kim,

Nam,

Sung

et al. 2024

J Korean Ophthalmol Soc

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Purpose: To compare the structural features of the optic nerve head (ONH) in moderate glaucoma patients with single-hemispheric and bi-hemispheric visual field (VF) defects.Methods: Patients with open-angle glaucoma (OAG) and a VF mean deviation between -6 and -12 dB were retrospectively enrolled. Based on VF defect patterns, eyes were classified into two groups: those with single-hemispheric VF defects and those with bi-hemispheric VF defects. Structural features analyzed included Bruch’s membrane opening area, lamina cribrosa (LC) thickness, temporal β-zone parapapillary atrophy with and without Bruch's membrane (βPPA+BM, βPPA-BM, respectively), and peripapillary retinal nerve fiber layer thickness using spectral-domain optical coherence tomography.Results: Out of 137 eyes from 124 patients, 80 eyes had single-hemispheric VF defects and 57 eyes had bi-hemispheric VF defects. The bi-hemispheric group exhibited longer axial length (p = 0.038), thinner central corneal thickness (p = 0.003), thinner LC (p < 0.001), and larger temporal βPPA+BM (p = 0.002) compared to the single-hemispheric group.Conclusions: Among Korean OAG patients with moderate VF defects, those with bi-hemispheric VF defects showed more structurally vulnerable optic discs characterized by longer axial lengths, thinner central corneal thickness, thinner LC, and larger β PPA+BM compared to those with single-hemispheric VF defects. These findings underline the importance of evaluating ONH structures in monitoring glaucoma progression particularly in patients with extensive VF damage.

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Hemisphere opposite to central retinal vascular trunk deviation is earlier affected by glaucomatous damage in primary angle‐closure glaucoma

Cited by 3 publications

References 28 publications

Association between eyeball asymmetry and offset of openings in optic nerve head canal assessed by posterior polar eyeball topography

Association between eyeball asymmetry and offset of openings in optic nerve head canal assessed by posterior polar eyeball topography

Optic nerve head factors associated with initial central visual field defect in primary open-angle glaucoma

Structural Features of Optic Nerve Head in Glaucoma with Single-hemispheric and Bi-hemispheric Visual Field Defects

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