Optic nerve head morphology in young patients after antiglaucomatous filtering surgery

Panda‐Jonas, Songhomitra; Xu, Liang; Yang, Hua; Wang, Ya X.; Jonas, Shefali B.

doi:10.1111/j.1755-3768.2012.02570.x

Cited by 18 publications

(12 citation statements)

References 31 publications

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“…The constancy of macular Bruch´s membrane length and the increase in the fovea-disc border distance by an enlargement of parapapillary gamma zone may imply that Bruch´s membrane is not strongly fixed on the underlying sclera through the choroid. Such a theory of a sliding Bruch´s membrane has also been discussed in a previous study in which the parapapillary region, presumably gamma zone, showed a marked decrease in size after a profound reduction in intraocular pressure for several months had occurred [ 37 ]. The concept of a Bruch´s membrane sliding by the swamping choroid on the sclera does not contradict a firm and stable relationship between Bruch´s membrane, the retinal pigment epithelium and the photoreceptors as basis for a stable visual function.…”

Section: Discussionmentioning

confidence: 90%

Macular Bruch´s Membrane Length and Axial Length. The Beijing Eye Study

et al. 2015

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PurposeTo assess whether macular Bruch´s membrane gets lengthened in axial myopia.MethodsUsing the enhanced depth imaging mode of spectral-domain optical coherence tomography and examining a subgroup of participants of the population-based cross-sectional Beijing Eye Study, we measured the length of Bruch´s membrane (“MacBMLength”) from the fovea to the temporal edge of parapapillary gamma zone, and the distance between the fovea and the temporal optic disc border. Parapapillary gamma zone was defined as the parapapillary region without Bruch´s membrane. We additionally measured ocular biometric parameters and assessed non-ophthalmologic variables.ResultsMeasurements of MacBMLength were performed on 322 individuals. MacBMLength (mean: 3.99±0.33 mm; range: 3.17–4.93 mm) was not significantly associated with any systemic parameter or ocular biometric parameter. Gamma zone width (mean: 0.18±0.30mm; range: 0.00–2.61mm) was associated (multivariate analysis; correlation coefficient r:0.80) with longer axial length (P<0.001; standardized correlation coefficient beta: 0.60; non-standardized correlation coefficient B:0.11; 95%CI: 0.09,0.14) and with longer fovea-optic disc border distance (P<0.001; beta:0.28; B:0.19; 95%CI:0.14,0.25), but not with MacBMLength (P = 0.42). Fovea-temporal disc border distance (mean: 4.16±0.44mm; range: 3.17–5.86mm) was associated (overall correlation coefficient: 0.68) with longer axial length (P<0.001; beta: 0.36; B: 0.10; 95%CI: 0.06, 0.13), after adjusting for flatter anterior chamber depth (P = 0.003; beta:-0.14; B:-0.14; 95%CI: -0.23,-0.05) and wider parapapillary gamma zone (P<0.001; beta:0.42; B:0.62; 95%CI:0.44,0.81).ConclusionsIn contrast to parapapillary gamma zone width and fovea-disc border distance, MacBMLength was not significantly associated with axial length. Axial elongation associated increase in fovea-disc distance may predominantly occur through development or elongation of parapapillary gamma zone, while macular Bruch´s membrane may mostly be independent of axial elongation.

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Section: Discussionmentioning

confidence: 90%

Macular Bruch´s Membrane Length and Axial Length. The Beijing Eye Study

et al. 2015

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“…The finding that the length of Bruch´s membrane as measured from the posterior pole to the end of parapapillary beta/gamma zone and the finding of an increase in the fovea-disc border distance by an enlargement of parapapillary gamma zone may imply that Bruch´s membrane is not firmly fixed on the underlying sclera through the choroid but may slightly slide. Sliding of Bruch´s membrane has already been discussed in a previous study in which parapapillary gamma zone markedly decreased in size after a profound reduction in intraocular pressure had occurred [ 27 ]. As an analogy, a sliding of the retinal pigment epithelium on Bruch´s membrane has recently been proposed to be involved in the etiology of parapapillary atrophy in glaucoma [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Optic Disc - Fovea Distance, Axial Length and Parapapillary Zones. The Beijing Eye Study 2011

et al. 2015

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PurposeTo measure the distance between the optic disc center and the fovea (DFD) and to assess its associations.MethodsThe population-based cross-sectional Beijing Eye Study 2011 included 3468 individuals aged 50+ years. The DFD was measured on fundus photographs.ResultsReadable fundus photographs were available for 2836 (81.8%) individuals. Mean DFD was 4.76 ± 0.34mm (median: 4.74 mm; range: 3.76–6.53mm). In multivariate analysis, longer DFD was associated with longer axial length (P<0.001; standardized correlation coefficient beta: 0.62), higher prevalence of axially high myopia (P<0.001; beta:0.06), shallower anterior chamber depth (P<0.001; beta:-0.18), thinner lens thickness (P = 0.004; beta: -0.06), smaller optic disc-fovea angle (P = 0.02; beta: -0.04), larger parapapillary alpha zone (P = 0.008; beta: 0.05), larger parapapillary beta/gamma zone (P<0.001; beta: 0.11), larger optic disc area (P<0.001; beta: 0.08), lower degree of cortical cataract (P = 0.002; beta: -0.08), and lower prevalence of age-related macular degeneration (P = 0.001; beta: -0.06). Bruch´s membrane opening-fovea distance (DFD minus disc radius minus parapapillary beta/gamma zone width) in non-glaucomatous eyes was not significantly (P = 0.60) related with axial length in emmetropic or axially myopic eyes (axial length ≥23.5 mm), while it increased significantly (P<0.001; r: 0.32) with longer axial length in eyes with an axial length of <23.5mm. Ratio of mean DFD to disc diameter was 2.65 ± 0.30. If the ratio of disc-fovea distance to disc diameter was considered constant and if the individual disc diameter was calculated as the individual disc-fovea distance divided by the constant factor of 2.65, the resulting calculated disc diameter differed from the directly measured disc diameter by 0.16 ±0.13 mm (median: 0.13 mm, range: 0.00–0.89 mm) or 8.9 ± 7.3% (median: 7.4%; range: 0.00–70%) of the measured disc diameter.ConclusionsDFD (mean: 4.76mm) increases with longer axial length, larger parapapillary alpha zone and parapapillary beta/gamma zone, and larger disc area. The axial elongation associated increase in DFD was due to an enlargement of parapapillary beta/gamma zone while the Bruch’s membrane opening-fovea distance did not enlarge with longer axial length. This finding may be of interest for the process of emmetropization and myopization. Due to its variability, the disc-fovea distance has only limited clinical value as a relative size unit for structures at the posterior pole.

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“…Wang et al 9 observed a folding of the RPE and a sliding of the end of RPE on BM under acute IOP elevation, which was associated with a transient enlargement of the peripapillary beta zone. Moreover, Panda-Jonas et al 34 observed changes in areas of peripapillary gamma zone in young glaucoma patients after marked surgical reduction of IOP. Our model showed that ONH deformations induced by eye movements are comparable or larger than those induced by a transient IOP 35 or CSFP increases 36 (see Supplementary Material SC), indicating a potential role for ocular movements in the development and progression of peripapillary zones.…”

Section: Discussionmentioning

confidence: 99%