Abstract
Purpose
To compare the lamina cribrosa (LC) depth of the optic nerve head in normal and glaucomatous eyes over a wide range of axial length (AXL).
Methods
A total of 402 eyes, including 210 normal and 192 glaucomatous eyes, were imaged by spectral domain optical coherence tomography. Normal and glaucomatous eyes were each divided into three subgroups according to the level of AXL; long (> 26 mm), mid-level (23–26 mm), and short (< 23 mm). Visual field mean deviation (VF MD), LC thickness, and LC depth were compared between normal and glaucomatous eyes in each of the AXL subgroups. These parameters were also compared between normal and glaucomatous eyes in the three AXL subgroups. Factors associated with LC depth in each AXL subgroup were evaluated by univariate and multivariate regression analyses.
Results
A comparison of the three AXL subgroups in normal eyes showed that the LC was thinnest in the long AXL subgroup (short; 189.7 ± 24.1 μm, mid-level; 179.9 ± 34.3 μm, long; 149.2 ± 36.2 μm, p < 0.001), but LC depth did not differ significantly in the three subgroups (short; 527.1 ± 144.4 μm, mid-level; 578.2 ± 163.5 μm, long; 594.4 ± 187.5 μm, p = 0.144). In glaucomatous eyes, glaucoma severity assessed by VF MD did not differ significantly among the three AXL subgroups (short; -6.99 ± 8.50 dB, mid-level; -6.40 ± 7.64 dB, long; -4.61 ± 5.22 dB, p = 0.168). However, LC depth was greater in the long than in the short AXL subgroup (679.5 ± 192.7 μm and 555.9 ± 134.1 μm, respectively, p = 0.004), although neither subgroup differed significantly in LC depth from the mid-level AXL subgroup (611.8 ± 162.3 μm, p = 0.385, p = 0.090). LC thickness was significantly different between normal and glaucomatous eyes (p < 0.001). LC depth was not different between normal and glaucomatous eyes in both short and mid-level AXL subgroups (p = 0.297, 0.222), but differed in the long AXL subgroup (p = 0.022). The presence of glaucoma was associated with greater LC depth only in the long AXL subgroup (p = 0.012).
Conclusions
LC depth may vary according to the level of AXL in glaucomatous eyes with a similar level of glaucoma severity, with the greatest LC depth found in eyes with long AXL. Those findings suggest that glaucomatous optic disc cupping would manifest differently according to the level of AXL.
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References
Lee KM, Kim TW, Weinreb RN, Lee EJ, Girard MJ, Mari JM (2014) Anterior lamina cribrosa insertion in primary open-angle glaucoma patients and healthy subjects. PLoS One 9, e114935
Quigley HA, Addicks EM, Green WR, Maumenee AE (1981) Optic nerve damage in human glaucoma. II. The site of injury and susceptibility to damage. Arch Ophthalmol 99:635–649
Quigley HA, Anderson DR (1977) Distribution of axonal transport blockade by acute intraocular pressure elevation in the primate optic nerve head. Invest Ophthalmol Vis Sci 16:640–644
Radius RL, Anderson DR (1981) Rapid axonal transport in primate optic nerve. Distribution of pressure-induced interruption. Arch Ophthalmol 99:650–654
Strouthidis NG, Fortune B, Yang H, Sigal IA, Burgoyne CF (2011) Longitudinal change detected by spectral domain optical coherence tomography in the optic nerve head and peripapillary retina in experimental glaucoma. Invest Ophthalmol Vis Sci 52:1206–1219
Lee EJ, Kim TW, Weinreb RN (2012) Reversal of lamina cribrosa displacement and thickness after trabeculectomy in glaucoma. Ophthalmology 119:1359–1366
Jonas JB, Berenshtein E, Holbach L (2004) Lamina cribrosa thickness and spatial relationships between intraocular space and cerebrospinal fluid space in highly myopic eyes. Invest Ophthalmol Vis Sci 45:2660–2665
Jonas JB, Xu L (2014) Histological changes of high axial myopia. Eye (Lond) 28:113–117
Kim S, Sung KR, Lee JR et al (2013) Evaluation of lamina cribrosa in pseudoexfoliation syndrome using spectral-domain optical coherence tomography enhanced depth imaging. Ophthalmology 120:1798–1803
Park HY, Jeon SH, Park CK (2012) Enhanced depth imaging detects lamina cribrosa thickness differences in normal tension glaucoma and primary open-angle glaucoma. Ophthalmology 119:10–20
Lee EJ, Kim TW, Kim M, Kim H (2015) Influence of Lamina Cribrosa Thickness and Depth on the Rate of Progressive Retinal Nerve Fiber Layer Thinning. Ophthalmology 122:721–729
Srinivasan VJ, Adler DC, Chen Y et al (2008) Ultrahigh-speed optical coherence tomography for three-dimensional and en face imaging of the retina and optic nerve head. Invest Ophthalmol Vis Sci 49:5103–5110
Inoue R, Hangai M, Kotera Y et al (2009) Three-dimensional high-speed optical coherence tomography imaging of lamina cribrosa in glaucoma. Ophthalmology 116:214–222
Kagemann L, Ishikawa H, Wollstein G et al (2008) Ultrahigh-resolution spectral domain optical coherence tomography imaging of the lamina cribrosa. Ophthalmic Surg Lasers Imaging 39(suppl):S126–S131
Strouthidis NG, Grimm J, Williams GA et al (2010) A comparison of optic nerve head morphology viewed by spectral domain optical coherence tomography and by serial histology. Invest Ophthalmol Vis Sci 51:1464–1474
Girard MJ, Strouthidis NG, Ethier CR, Mari JM (2011) Shadow removal and contrast enhancement in optical coherence tomography images of the human optic nerve head. Invest Ophthalmol Vis Sci 52:7738–7748
Kim TW, Kagemann L, Girard MJ, Strouthidis NG, Sung KR, Leung CK et al (2013) Imaging of the lamina cribrosa in glaucoma: perspectives of pathogenesis and clinical applications. Curr Eye Res 38:903–909
Lee EJ, Kim TW, Weinreb RN et al (2011) Visualization of the lamina cribrosa using enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 152:87–95
Park SC, De Moraes CG, Teng CC et al (2012) Enhanced depth imaging optical coherence tomography of deep optic nerve complex structures in glaucoma. Ophthalmology 119:3–9
Wang B, Nevins JE, Nadler Z, Wollstein G, Ishikawa H, Bilonick RA et al (2013) In-Vivo Lamina Cribrosa Microarchitecture in Healthy and Glaucomatous Eyes as Assessed by Optical Coherence Tomography. Invest Ophthalmol Vis Sci 54:8270–8274
Chung HS, Sung KR, Lee KS, Lee JR, Kim S (2014) Relationship between the lamina cribrosa, outer retina, and choroidal thickness as assessed using spectral domain optical coherence tomography. Korean J Ophthalmol 28:234–240
Marcus MW, de Vries MM, JunoyMontolio FG et al (2011) Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. Ophthalmology 118:1989–1994
Wong TY, Foster PJ, Hee J et al (2000) Prevalence and risk factors for refractive errors in adult Chinese in Singapore. Invest Ophthalmol Vis Sci 41:2486–2494
Chon B, Qiu M, Lin SC (2013) Myopia and glaucoma in the South Korean population. Invest Ophthalmol Vis Sci 54:6570–6577
Lee JY, Sung KR, Han S, Na JH (2015) Effect of myopia on the progression of primary open angle glaucoma. Invest Ophthalmol Vis Sci 56:1775–1781
Park SC, Brumm J, Furlanetto RL, Netto CF, Liu Y, Tello C, Liebmann JM, Ritch R (2015) Lamina Cribrosa Depth in Different Stages of Glaucoma. Invest Ophthalmol Vis Sci 56:2059–2064
Kim M, Kim TW, Weinreb RN, Lee EJ (2013) Differentiation of parapapillary atrophy using spectral-domain optical coherence tomography. Ophthalmology 120:1790–1797
Na JH, Moon BG, Sung KR, Lee Y, Kook MS (2010) Characterization of peripapillaryatrophy using spectral domain optical coherence tomography. Korean J Ophthalmol 24:353–359
Acknowledgments
This study was supported by a grant (2013-0513) from the Asan Medical Center, Seoul, Korea, grant (2013-500) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea, and the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science, and Technology (NRF-2014R1A1A3A04051089).
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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) in the subject matter or materials discussed in this manuscript.
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Yun, SC., Hahn, I.K., Sung, K.R. et al. Lamina cribrosa depth according to the level of axial length in normal and glaucomatous eyes. Graefes Arch Clin Exp Ophthalmol 253, 2247–2253 (2015). https://doi.org/10.1007/s00417-015-3131-y
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DOI: https://doi.org/10.1007/s00417-015-3131-y