Positional Change of Optic Nerve Head Vasculature during Axial Elongation as Evidence of Lamina Cribrosa Shifting

Lee, Kyoung Min; Choung, Ho Kyung; Kim, Martha; Oh, Sohee; Kim, Seok Hwan

doi:10.1016/j.ophtha.2018.02.002

Cited by 98 publications

(107 citation statements)

References 31 publications

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“…28,29 Third, whereas BMO has become a clinically accepted reference landmark for OCT neuroretinal rim measurements, ASCO has only recently begun to be identified in OCT images. 28,29 Fourth, although BMO size and position may change with age, 28,30,41,68 and myopia, 62,72 our data suggest that ASCO size also decreases with age, and previous studies have shown that the ASCO expands and bows outward, in monkey experimental glaucoma. 73,74 Thus ASCO may not be more stable than BMO as a reference for our measurements.…”

Section: This Study Introduces the Use Of Oct Imaging Tosupporting

confidence: 53%

“…In myopia, BMO has been shown to shift temporally relative to the ASCO 62,64 ; however, which opening is stable and which opening is moving cannot be determined. Our choice of BMO as the reference landmark for ASCO/ BMO offset assessment does not infer that the ASCO has moved relative to BMO nor does it infer that BMO has moved relative to the ASCO.…”

Section: This Study Introduces the Use Of Oct Imaging Tomentioning

confidence: 99%

“…However, in this study, we address them individually in part because the phenomenon underlying the term ''ASCO/BMO offset'' is more clinically intuitive than the term ''neural canal direction'' and in part because it has been suggested that the relationship between the ASCO and BMO longitudinally changes as part of progressive myopia. [62][63][64] We suggest that ''ASCO/BMO offset'' be used when talking about processes that primarily affect these structures. We suggest that ''neural canal'' be used when talking about the RGC axon pathway through the eye wall and/or the amount and susceptibility of its neuronal contents.…”

Section: This Study Introduces the Use Of Oct Imaging Tomentioning

confidence: 99%

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OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness, and Minimum Cross-Sectional Area in Healthy Eyes

Hong

Yang

Gardiner

et al. 2019

American Journal of Ophthalmology

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To assess anterior scleral canal opening (ASCO) offset relative to Bruch's membrane opening (BMO) (ASCO/BMO offset) so as to determine neural canal direction, obliqueness, and minimum crosssectional area (NCMCA) in 362 healthy eyes. DESIGN: Cross-sectional study. METHODS: After optical coherence tomography optic nerve head and retinal nerve fiber layer thickness (RNFLT) imaging, BMO and ASCO were manually segmented. Planes, centroids, size, and shape were calculated. Neural canal direction was defined by projecting the neural canal axis vector (connecting BMO and ASCO centroids) onto the BMO plane. Neural canal obliqueness was defined by the angle between the neural canal axis and the BMO plane perpendicular vector. NCMCA was defined by projecting BMO and ASCO points onto a neural canal axis perpendicular plane and measuring the area of overlap. The angular distance between superior and inferior peak RNFLT was measured, and correlations between RFNLT, BMO, ASCO, ASCO/ BMO offset, and NCMCA were assessed. RESULTS: Mean (SD) NCMCA was significantly smaller than either the BMO or ASCO area (1.33 (0.42), 1.82 (0.38), 2.22 (0.43) mm 2 , respectively), and most closely correlated to RNFLT (P < .001, R 2 [ 0.158). Neural canal direction was most commonly superior-nasal (55%). Mean neural canal obliqueness was 39.4 8 (17.3 8). The angular distance between superior and inferior peak RNFLT correlated to neural canal direction (P £ .008, R 2 [ 0.093). CONCLUSIONS: ASCO/BMO offset underlies neural canal direction, obliqueness, and NCMCA. RNFLT is more strongly correlated to NCMCA than to BMO or ASCO, and its peripapillary distribution is influenced by neural canal direction.

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Section: This Study Introduces the Use Of Oct Imaging Tosupporting

confidence: 53%

Section: This Study Introduces the Use Of Oct Imaging Tomentioning

confidence: 99%

Section: This Study Introduces the Use Of Oct Imaging Tomentioning

confidence: 99%

See 1 more Smart Citation

OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness, and Minimum Cross-Sectional Area in Healthy Eyes

Hong

Yang

Gardiner

et al. 2019

American Journal of Ophthalmology

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“…Regarding the reason for the location of PPA −BM (most PPA −BM is found at the temporal side of the ONH), possibly the concomitant nasal shifting of LC might cause the asymmetric stretching of nasal and temporal peripapillary border tissue, thus resulting in enlargement of the PPA −BM mostly at the temporal side of the ONH. Recently, Kim et al 7,22,23 introduced the concept of LC nasal shifting during myopia progression after the prospective longitudinal observation www.nature.com/scientificreports www.nature.com/scientificreports/ of the ONH in South Korean children. However, this concept is only a hypothesis and it has not been scientifically confirmed, thus future longitudinal investigations might be needed to confirm our assumption.…”

Section: Discussionmentioning

confidence: 99%

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Sung

Heo

Piao

et al. 2020

Sci Rep

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We investigated the relationship between microstructure of β-parapapillary atrophy (β-ppA) and morphologic features of optic nerve head (onH) and posterior pole in highly myopic eyes. eighty-nine highly myopic eyes were included in this study. Bruch's membrane opening (BMo) area, lamina cribrosa (Lc) thickness, anterior laminar depth, peripapillary and subfoveal choroidal thickness (ct), macular Bruch's membrane (BM) length, and width of β-ppA with and without Bruch's membrane (ppA +BM and ppA −BM ) were evaluated. The mean age and axial length of the included subjects were 26.88 ± 2.44 years and 27.03 ± 0.88 mm, respectively. The width of PPA −BM was larger with increasing BMo area (P = 0.001), whereas the BMO area was not associated with the width of PPA +BM . the large ppA +BM was significantly related to a thinner LC (P = 0.003), deeper anterior lamina surface (P < 0.001), longer macular BM length (P = 0.008), and thinner temporal peripapillary CT (P = 0.034). We found that the morphologic features of the ONH and posterior pole in highly myopic eyes were different based on the microstructure of β-ppA. Whether these features are linked to the development of glaucoma in myopic eyes should be investigated in future studies.Classic funduscopic β-parapapillary atrophy (β-PPA) is a region of visible large choroidal vessels and sclera due to the lack of retinal pigment epithelium (RPE). β-PPA can be histologically subclassified based on the presence or absence of Bruch's membrane (BM): β-PPA with BM (PPA +BM ; β zone) and β-PPA without BM (PPA −BM ; γ zone). It has been known that PPA +BM might be due to age-related atrophy of the RPE and associated with the development of glaucoma 1-4 . Whereas, PPA −BM has been considered as a result of mechanical stretching in the peripapillary sclera and border tissue during axial elongation; hence a significant association between axial length and PPA −BM width has been consistently reported 1-3,5 . However, we previously reported that PPA +BM was also found in 20-30-year-old myopia subjects and suggested that PPA +BM in young myopia patients might be related to axial elongation, not age-related atrophy 6 . In accordance with our report, Lee et al. 7 recently found an enlargement of PPA +BM as myopia progressed and proposed that PPA +BM found in children might be an entirely different entity from PPA +BM in elderly individuals, sharing an etiology with PPA −BM .Several factors might contribute to β-PPA development during axial elongation, but the etiology of PPA +BM and PPA −BM enlargement remains elusive so far. It is unclear why some myopia patients exhibit only PPA −BM , whereas others with a similar degree of myopia exhibit both PPA +BM and PPA −BM . In this study, we hypothesized that morphologic features of the optic nerve head (ONH) and the posterior pole might give clues to the mechanisms of differential developments of β-PPA in myopic eyes. Therefore, the purpose of this work was to investigate the relationship between microstructure of β-PPA and the morphologic featur...

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“…The adjacent retinal tissue extends externally, and this mechanical stretching results in morphological changes in vessel and tissue thickness. During β-PPA, the shape of vessels becomes straighter and thinner, which may affect vessel flow in the macular region [14]. Furthermore, the changes in vessel thickness may damage endothelial cells and subsequently reduce the concentration of vascular endothelial growth factor [15,16].…”

Section: Hua Fan and Associatesmentioning

confidence: 99%

Correlation between optic disc deformation and retinal vasculature in non-pathological high myopia

Sun

Wang

2019

Preprint

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Background: The aim of this study was to investigate the correlation between optic disc deformation and retinal vasculature in high myopia.Methods: One hundred and thirty eyes with non-pathological high myopia were included in this cross-sectional study. The optic disc tilt ratio, and horizontal and vertical disc diameters were analyzed using fundus color photography. A 3 × 3 mm2 grid and a 4.5 × 4.5 mm2 grid were used to scan parafoveal and peripapillary regions, respectively, using optical coherence tomography angiography. Vessel flow density (VFD) and fractal dimension of the retina and the foveal avascular zone (FAZ) were analyzed and quantified using en face projection images. Optic disc parameters that were associated with vascular changes were determined using multiple linear regression analysis.Results: Results from the multivariate analysis revealed that the tilt ratio (β = -2.291, p = 0.025) was negatively correlated with three sectors in the deep layer. Age was negatively correlated with the VFD of the retina (β = -2.161; p < 0.034). Additionally, FAZ was not significantly correlated with any factors in the current study. Further, there was a positive correlation between retinal nerve fiber layer thickness and VFD of the optic nerve head (β = -2.146, p = 0.035).Conclusions: Overall, our results demonstrated that optic disc deformation was negatively correlated with the retinal microvasculature in non-pathological high myopia. Therefore, optic disc deformation may be used to predict the retinal vasculature in high myopia.

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Positional Change of Optic Nerve Head Vasculature during Axial Elongation as Evidence of Lamina Cribrosa Shifting

Cited by 98 publications

References 31 publications

OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness, and Minimum Cross-Sectional Area in Healthy Eyes

OCT-Detected Optic Nerve Head Neural Canal Direction, Obliqueness, and Minimum Cross-Sectional Area in Healthy Eyes

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Correlation between optic disc deformation and retinal vasculature in non-pathological high myopia

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