Reversal of lamina cribrosa displacement after intraocular pressure reduction in open-angle glaucoma.

To compare the change in lamina cribrosa (LC) displacement in response to intraocular pressure (IOP) lowering in patients with open-angle glaucoma (OAG) using spectral-domain optical coherence tomography (SD-OCT). Observational case series. One hundred eyes of 100 patients with OAG in whom IOP at the follow-up examination had decreased by at least 20% compared with the baseline IOP. Serial horizontal B-scan images of the optic nerve head (ONH) were obtained from each eye using enhanced depth imaging SD-OCT. Approximately 65 B-scans covering the optic discs were obtained before and 3 to 6 months after lowering IOP. The baseline and follow-up LC depths (the distance from the Bruch's membrane opening plane to the level of the anterior LC surface) were measured in B-scan images from each eye. The mean and maximum amount of reductions in LC depth measured in the 7 selected B-scan images. Intraocular pressure decreased from 21.2±9.1 to 10.5±2.6 mmHg. The percent of IOP reduction was significantly related to the untreated IOP (P < 0.001). There was a significant decrease in the LC depth at the follow-up examination compared with the baseline value (P < 0.001). The magnitude of LC depth reduction was significantly associated with younger age, higher untreated IOP, higher baseline IOP, and greater percent of IOP reduction (all P < 0.02). Reversal of the LC displacement was observed after IOP-lowering treatment in OAG. The degree of LC displacement reversal was related to the amount of IOP lowering.

Lee EJ ，Kim TW ，Weinreb RN ，Kim H ... -  《-》

Reversal of lamina cribrosa displacement and thickness after trabeculectomy in glaucoma.

To investigate the response of the lamina cribrosa (LC) and prelaminar tissue to glaucoma surgery using spectral-domain optical coherence tomography (SD-OCT) and to determine the factors influencing such responses. Observational case series. Thirty-five eyes of 35 primary open-angle glaucoma patients who underwent trabeculectomy. Patients were imaged using a 10 × 15-degree rectangle covering the optic disc using SD-OCT. About 65 B-scans covering the optic discs were obtained using enhanced depth imaging SD-OCT before surgery, after 1 week, and 1, 3, and 6 months postoperatively. The pre- and postoperative magnitude of the LC displacement (distance from the Bruch's membrane opening plane to the level of anterior LC surface) and the thickness of LC and prelaminar tissue were determined on 7 to 13 selected B-scan images in each eye. The amount of reduction in the LC displacement and changes in the thickness of LC and prelaminar tissue. Intraocular pressure (IOP) was decreased from 27.2 ± 8.9 mmHg (range, 14-47) to 10.5 ± 3.4 mmHg (range, 6-21) at postoperative month 6. The amount of posterior displacement of the LC was significantly decreased from a mean preoperative level of 614.58 ± 179.57 to 503.90 ± 142.67 μm at postoperative month 6 (P<0.001). The thicknesses of the LC and prelaminar tissue were significantly increased at postoperative month 6 (P<0.001 and P = 0.048, respectively). The magnitude of the reduction in the LC displacement was significantly associated with younger age (P<0.001), greater percent IOP reduction (P = 0.019), and greater preoperative LC displacement (P = 0.024). None of the factors was associated with the amount of LC or prelaminar tissue thickening. A significant reduction in the posterior displacement and increase in the thickness of the LC and prelaminar tissue were demonstrated after glaucoma surgery using enhanced depth imaging SD-OCT of the optic nerve head. The amount of reduction in the LC displacement was associated with younger age, larger baseline LC displacement, and greater IOP reduction.

Lee EJ ，Kim TW ，Weinreb RN 《-》

Long-Term Shape, Curvature, and Depth Changes of the Lamina Cribrosa after Trabeculectomy.

To evaluate changes in lamina cribrosa (LC) shape, curvature, and depth after trabeculectomy. Prospective, observational case series. A total of 112 patients (118 eyes) with open- or closed-angle glaucoma undergoing trabeculectomy. The optic nerve head was imaged using enhanced depth imaging spectral-domain OCT before trabeculectomy and at 6 follow-up visits throughout the first postoperative year. The anterior LC surface and Bruch's membrane opening were marked in the serial horizontal B scans for the analysis of LC parameters using Morphology 1.0 software. Postoperative morphologic LC changes were assessed. The postoperative LC global shape index (GSI), nasal-temporal (N-T) and superior-inferior (S-I) curvatures, and mean and sectoral LC depth (LCD). The mean LC GSI increased only during the early postoperative period (P = 0.02), resulting in a change toward the saddle-rut shape. There was a flattening of the LC curvature in N-T (P < 0.001) and S-I (P = 0.003) meridians 12 months after trabeculectomy. A shallowing of the mean and sectoral LCD from baseline was significant throughout the entire follow-up period (P < 0.001) and progressed up to postoperative month 6. Twenty-eight patients showed a deepening of the LC from baseline in at least 1 visit. Eyes with shallower LCD compared with baseline responded to intraocular pressure (IOP) reduction with greater movement anteriorly than eyes with deeper LCD (P = 0.002). Greater IOP reduction (P = 0.007), less retinal nerve fiber layer thinning over the year (P = 0.003), and more superiorly-inferiorly curved baseline LC (P = 0.001) were associated with an increase in GSI. Younger age and IOP reduction were related to LC shallowing (P < 0.001, P = 0.002) and N-T flattening (P < 0.001). In most eyes, trabeculectomy resulted in long-term flattening and shallowing of the LC. However, in some eyes, LC deepened from baseline. Change in LC global shape appeared to be temporal. Reduction in IOP plays an important role in the early phase of LC change; however, in the later phase, LC remodeling may play a crucial role in view of stable IOP.

Kadziauskienė A ，Jašinskienė E ，Ašoklis R ，Lesinskas E ，Rekašius T ，Chua J ，Cheng CY ，Mari JM ，Girard MJA ，Schmetterer L ... -  《-》

Evaluating displacement of lamina cribrosa following glaucoma surgery.

Krzyżanowska-Berkowska P ，Melińska A ，Helemejko I ，Robert Iskander D ... -  《-》

Laminar displacement and prelaminar tissue thickness change after glaucoma surgery imaged with optical coherence tomography.

Reis AS ，O'Leary N ，Stanfield MJ ，Shuba LM ，Nicolela MT ，Chauhan BC ... -  《-》