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Lamina cribrosa defects and optic disc morphology in primary open angle glaucoma with high myopia.

Kimura Y, Akagi T, Hangai M, Takayama K, Hasegawa T, Suda K, Yoshikawa M, Yamada H, Nakanishi H, Unoki N, Ikeda HO, Yoshimura N - PLoS ONE (2014)

Bottom Line: Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects.Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA) lengths with and without Bruch's membrane (BM) (temporal, nasal, superior, and inferior), tilt angle (vertical and horizontal), and disc diameter (transverse and longitudinal).Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

ABSTRACT

Purpose: To investigate whether lamina cribrosa (LC) defects are associated with optic disc morphology in primary open angle glaucoma (POAG) eyes with high myopia.

Methods: A total of 129 POAG patients and 55 age-matched control subjects with high myopia were evaluated. Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects. Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA) lengths with and without Bruch's membrane (BM) (temporal, nasal, superior, and inferior), tilt angle (vertical and horizontal), and disc diameter (transverse and longitudinal). Peripapillary intrachoroidal cavitations (PICCs), disc area, ovality index, and cyclotorsion of the optic disc were analyzed as well.

Results: LC defects were found in 70 of 129 (54.2%) POAG eyes and 1 of 55 (1.8%) control eyes (P < 0.001). Age, sex, spherical equivalent, axial length, intraocular pressure, and central corneal thickness were not significantly different among POAG eyes with LC defects, POAG eyes without LC defects, and control eyes. Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle. PICCs were detected more frequently in POAG eyes with LC defects than those without LC defects (P = 0.01) and control eyes (P = 0.02). POAG eyes with LC defects showed a smaller ovality index (P = 0.004), longer temporal PPA without BM (P < 0.001), and larger vertical/horizontal tilt angles (vertical, P < 0.001; horizontal, P = 0.01), and transverse diameter (P = 0.01). In multivariate analysis for the presence of LC defects, presence of POAG (P < 0.001) and vertical tilt angle (P < 0.001) were identified as significant.

Conclusions: The presence of LC defects was associated with myopic optic disc morphology in POAG eyes with high myopia.

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Representative cases of a healthy highly myopic eye with enlarged lamina pores (A–E) and an eye with primary open angle glaucoma and lamina cribrosa (LC) defects (F–J).(A) A lamina pore can be seen within the optic disc cup (red arrowhead) in the optic disc photograph. (B) Multiple hyporeflective dots and a large hyporeflective region (red arrowhead) can be interpreted as lamina pores in en face optic disc images at the level of the LC. (C) Humphrey 24-2 pattern deviation plots show no glaucomatous visual field defect. Volume image (D) and horizontal B-scan image (E) corresponding to the green dotted line in (A). Note that the lamina structure was not fully defective in the hyporeflective region. (F) The LC defect can be seen in the inferior border of the optic disc rim (red arrowhead). (G) A wedge shaped hyporeflective region (red arrowhead) is also apparent in the en face image. (H) Humphrey 24-2 pattern deviation plots showed a glaucomatous visual field defect. Volume image (I) and horizontal B scan image (J) corresponding to the green dotted arrow in (F). Note that the lamina structure was fully defective in the hyporeflective region.
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pone-0115313-g003: Representative cases of a healthy highly myopic eye with enlarged lamina pores (A–E) and an eye with primary open angle glaucoma and lamina cribrosa (LC) defects (F–J).(A) A lamina pore can be seen within the optic disc cup (red arrowhead) in the optic disc photograph. (B) Multiple hyporeflective dots and a large hyporeflective region (red arrowhead) can be interpreted as lamina pores in en face optic disc images at the level of the LC. (C) Humphrey 24-2 pattern deviation plots show no glaucomatous visual field defect. Volume image (D) and horizontal B-scan image (E) corresponding to the green dotted line in (A). Note that the lamina structure was not fully defective in the hyporeflective region. (F) The LC defect can be seen in the inferior border of the optic disc rim (red arrowhead). (G) A wedge shaped hyporeflective region (red arrowhead) is also apparent in the en face image. (H) Humphrey 24-2 pattern deviation plots showed a glaucomatous visual field defect. Volume image (I) and horizontal B scan image (J) corresponding to the green dotted arrow in (F). Note that the lamina structure was fully defective in the hyporeflective region.

Mentions: The evaluation of LC defects was performed as previously described [29]. In brief, the SS-OCT image set was independently reviewed for focal LC defects by two graders (KT and YK), who were masked to all other information. An LC defect was defined as a loss of high reflectivity from the anterior-to-posterior border of the full-thickness LC on vertical/horizontal serial B-scan images and a minimum width of hyporeflectivity of >100 µm on en-face images (Figs. 2 and 3)[26].


Lamina cribrosa defects and optic disc morphology in primary open angle glaucoma with high myopia.

Kimura Y, Akagi T, Hangai M, Takayama K, Hasegawa T, Suda K, Yoshikawa M, Yamada H, Nakanishi H, Unoki N, Ikeda HO, Yoshimura N - PLoS ONE (2014)

Representative cases of a healthy highly myopic eye with enlarged lamina pores (A–E) and an eye with primary open angle glaucoma and lamina cribrosa (LC) defects (F–J).(A) A lamina pore can be seen within the optic disc cup (red arrowhead) in the optic disc photograph. (B) Multiple hyporeflective dots and a large hyporeflective region (red arrowhead) can be interpreted as lamina pores in en face optic disc images at the level of the LC. (C) Humphrey 24-2 pattern deviation plots show no glaucomatous visual field defect. Volume image (D) and horizontal B-scan image (E) corresponding to the green dotted line in (A). Note that the lamina structure was not fully defective in the hyporeflective region. (F) The LC defect can be seen in the inferior border of the optic disc rim (red arrowhead). (G) A wedge shaped hyporeflective region (red arrowhead) is also apparent in the en face image. (H) Humphrey 24-2 pattern deviation plots showed a glaucomatous visual field defect. Volume image (I) and horizontal B scan image (J) corresponding to the green dotted arrow in (F). Note that the lamina structure was fully defective in the hyporeflective region.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4274005&req=5

pone-0115313-g003: Representative cases of a healthy highly myopic eye with enlarged lamina pores (A–E) and an eye with primary open angle glaucoma and lamina cribrosa (LC) defects (F–J).(A) A lamina pore can be seen within the optic disc cup (red arrowhead) in the optic disc photograph. (B) Multiple hyporeflective dots and a large hyporeflective region (red arrowhead) can be interpreted as lamina pores in en face optic disc images at the level of the LC. (C) Humphrey 24-2 pattern deviation plots show no glaucomatous visual field defect. Volume image (D) and horizontal B-scan image (E) corresponding to the green dotted line in (A). Note that the lamina structure was not fully defective in the hyporeflective region. (F) The LC defect can be seen in the inferior border of the optic disc rim (red arrowhead). (G) A wedge shaped hyporeflective region (red arrowhead) is also apparent in the en face image. (H) Humphrey 24-2 pattern deviation plots showed a glaucomatous visual field defect. Volume image (I) and horizontal B scan image (J) corresponding to the green dotted arrow in (F). Note that the lamina structure was fully defective in the hyporeflective region.
Mentions: The evaluation of LC defects was performed as previously described [29]. In brief, the SS-OCT image set was independently reviewed for focal LC defects by two graders (KT and YK), who were masked to all other information. An LC defect was defined as a loss of high reflectivity from the anterior-to-posterior border of the full-thickness LC on vertical/horizontal serial B-scan images and a minimum width of hyporeflectivity of >100 µm on en-face images (Figs. 2 and 3)[26].

Bottom Line: Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects.Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA) lengths with and without Bruch's membrane (BM) (temporal, nasal, superior, and inferior), tilt angle (vertical and horizontal), and disc diameter (transverse and longitudinal).Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

ABSTRACT

Purpose: To investigate whether lamina cribrosa (LC) defects are associated with optic disc morphology in primary open angle glaucoma (POAG) eyes with high myopia.

Methods: A total of 129 POAG patients and 55 age-matched control subjects with high myopia were evaluated. Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects. Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure β-peripapillary atrophy (PPA) lengths with and without Bruch's membrane (BM) (temporal, nasal, superior, and inferior), tilt angle (vertical and horizontal), and disc diameter (transverse and longitudinal). Peripapillary intrachoroidal cavitations (PICCs), disc area, ovality index, and cyclotorsion of the optic disc were analyzed as well.

Results: LC defects were found in 70 of 129 (54.2%) POAG eyes and 1 of 55 (1.8%) control eyes (P < 0.001). Age, sex, spherical equivalent, axial length, intraocular pressure, and central corneal thickness were not significantly different among POAG eyes with LC defects, POAG eyes without LC defects, and control eyes. Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle. PICCs were detected more frequently in POAG eyes with LC defects than those without LC defects (P = 0.01) and control eyes (P = 0.02). POAG eyes with LC defects showed a smaller ovality index (P = 0.004), longer temporal PPA without BM (P < 0.001), and larger vertical/horizontal tilt angles (vertical, P < 0.001; horizontal, P = 0.01), and transverse diameter (P = 0.01). In multivariate analysis for the presence of LC defects, presence of POAG (P < 0.001) and vertical tilt angle (P < 0.001) were identified as significant.

Conclusions: The presence of LC defects was associated with myopic optic disc morphology in POAG eyes with high myopia.

Show MeSH
Related in: MedlinePlus