Comparing the lamina cribrosa in eyes with primary open angle glaucoma and chronic primary angle closure glaucoma_Chinese Journal of Ocular Fundus Diseases

Authors：

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China;

Corresponding author：

Keywords：

Glaucoma; open-angle/diagnosis; Glaucoma; angle-closure/diagnosis; Tomography; optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2016.06.013

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Objective To compare the lamina cribrosa parameters between primary open angle glaucoma (POAG) and chronic primary angle closure glaucoma (CPACG) eyes. Methods A total of 73 POAG eyes (73 subjects), 64 CPACG eyes (64 subjects), and 40 normal control eyes (40 subjects) with matched ages were included in this cross-sectional observational study. No significant difference was found in sex (χ²=2.07) and age (F=0.38) among three groups (P > 0.05). The intraocular pressure, average retinal nerve fiber layer (RNFL) thickness and average visual field defect were not significantly different between POAG and CPACG patients (F=15.67, 21.15, 44.40, 27.99; P < 0.05). All subjects underwent spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI). The optic nerve head was scanned radially at the angle of 20; six high resolution B-scan images were obtained from each eye. The center and para-center lamina cribrosa thickness (LCT) and anterior lamina cribrosa surface depth (ALCSD) were measured in each image. The mean LCT and ALCSD were recorded as the average of the LCT and ALCSD of the 6 images and compared among POAG, CPACG and normal control eyes. Results The average LCT of normal control eyes were (211.48±12.07) μm, while those of the POAG eyes were (145.43±34.33) μm, CPACG eyes were (156.79±33.66) μm. The mean LCT of the POAG and CPACG eyes were thinner than those of the control eyes (t=-11.76, -9.88; P < 0.01). All LCT of the POAG eyes were significantly thinner than those of the CPACG eyes (t=-1.96, P=0.03).The average ALCSD of normal control eyes were (390.73±84.40) μm, while those of the POAG eyes were (558.51±176.66) μm, CPACG eyes were (539.39±177.30) μm, respectively. The average ALCSD of the POAG and CPACG eyes were deeper than those of the control eyes (t=5.65, 4.96; P < 0.01). But no significantly different ALCSD was shown between POAG and CPACG eyes (t=0.63, P=0.49). Conclusions POAG and CPACG eyes have thinner LCT and deeper ALCSD than normal eyes. POAG eyes have thinner LCT than CPACG eyes when their visual field defect and damage of RNFL were in the same degree.

Citation： HaoLinlin, XiaoHui, ChenXiangxi, MiLan, LiaoLingling, LiuXing. Comparing the lamina cribrosa in eyes with primary open angle glaucoma and chronic primary angle closure glaucoma. Chinese Journal of Ocular Fundus Diseases, 2016, 32(6): 619-623. doi: 10.3760/cma.j.issn.1005-1015.2016.06.013 Copy

1.	Quigley HA, Addicks EM, Green WR, et al. Optic nerve damage in human glaucoma. Ⅱ. The site of injury and susceptibility to damage[J]. Arch Ophthalmol, 1981, 99(4):635-649.
2.	Quigley HA, Hohman RM, Addicks EM, et al. Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma[J].Am J Ophthalmol, 1983, 95(5):673-691.
3.	Lee EJ, Kim TW, Weinreb RN, et al. Visualization of the lamina cribrosa using enhanced depth imaging spectral-domain optical coherence tomography[J].Am J Ophthalmol, 2011, 152(1):87-95. DOI:10.1016/j.ajo.2011.01.024.
4.	Park SC, Ritch R. High resolution in vivo imaging of the lamina cribrosa[J]. Saudi J Ophthalmol, 2011, 25(4):363-372. DOI:10.1016/j.sjopt.2011.07.007.
5.	Emery JM, Landis D, Paton D, et al. The lamina cribrosa in normal and glaucomatous human eyes[J]. Trans Am Acad Ophthalmol Otolaryngol, 1974, 78(2):290-297.
6.	Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J]. Am J Ophthalmol, 2015, 159(3):512-518. DOI:10.1016/j.ajo.2014.11.034.
7.	Furlanetto RL, Park SC, Damle UJ, et al. Posterior displacement of the lamina cribrosa in glaucoma:in vivo interindividual and intereye comparisons[J].Invest Ophthalmol Vis Sci, 2013, 54(7):4836-4842. DOI:10.1016/iovs.12-11530.
8.	Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J]. Am J Ophthalmol, 2015, 159(3):512-518. DOI:10.1016/j.ajo.2014.11.034.
9.	Faridi OS, Park SC, Kabadi R, et al. Effect of focal lamina cribrosa defect on glaucomatous visual field progression[J]. Ophthalmology, 2014, 121(8):1524-1530. DOI:10.1016/j.ophtha.2014.02.017.
10.	Quigley HA, Katz J, Derick RJ, et al. An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage[J]. Ophthalmology, 1992, 99(1):19-28.
11.	Howell GR, Libby RT, Jakobs TC, et al. Axons of retinal ganglion cells are insulted in the optic nerve early in DBA/2J glaucoma[J].J Cell Biol, 2007, 179(7):1523-1537.
12.	Buckingham BP, Inman DM, Lambert W, et al. Progressive ganglion cell degeneration precedes neuronal loss in a mouse model of glaucoma[J]. J Neurosci, 2008, 28(11):2735-2744.DOI:10.1523/JNEUROSCI.4443-07.2008.
13.	Harwerth RS, Carter-Dawson L, Shen F, et al. Ganglion cell losses underlying visual field defects from experimental glaucoma[J].Invest Ophthalmol Vis Sci, 1999, 40(10):2242-2250.
14.	Burgoyne CF, Downs JC, Bellezza AJ, et al. The optic nerve head as a biomechanical structure:a new paradigm for understanding the role of IOP-related stress and strain in the pathophysiology of glaucomatous optic nerve head damage[J].Prog Retin Eye Res, 2005, 24(1):39-73.
15.	Shrout PE. Measurement reliability and agreement in psychiatry[J]. Stat Methods Med Res, 1998, 7(3):301-317.
16.	Park HY, Jeon SH, Park CK. Enhanced depth imaging detects lamina cribrosa thickness differences in normal tension glaucoma and primary open angle glaucoma[J]. Ophthalmology, 2012, 119(1):10-20. DOI:10.1016/j.ophtha.2011.07.033.
17.	Ren R, Wang N, Li B, et al. Lamina cribrosa and peripapillary sclera histomorphometry in normal and advanced glaucomatous Chinese eyes with various axial length[J].Invest Ophthalmol Vis Sci, 2009, 50(5):2175-2184.DOI:10.1167/iovs.07-1429.
18.	Jung KI, Jung Y, Park KT, et al.Factors affecting plastic lamina cribrosa displacement in glaucoma patients[J].Invest Ophthalmol Vis Sci, 2014, 55(12):7709-7715. DOI:10.1167/iovs. 14-13957.
19.	Lee EJ, Kim TW, Weinreb RN. Reversal of lamina cribrosa displacement and thickness after trabeculectomy in glaucoma[J].Ophthalmology, 2012, 119(7):1359-1366. DOI:10. 1016/j.ophtha. 2012.01.034.
20.	Park SC, Brumm J, Furlanetto RL, et al. Lamina cribrosa depth in different stages of glaucoma[J].Invest Ophthalmol Vis Sci, 2015, 56(3):2059-2064. DOI:10.1167/iovs. 14-15540.
21.	Furlanetto RL, Park SC, Damle UJ, et al.Posterior displacement of the lamina cribrosa in glaucoma:in vivo interindividual and intereye comparisons[J].Invest Ophthalmol Vis Sci, 2013, 54(7):4836-4842. DOI:10.1167/iovs.12-11530.
22.	Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J].Am J Ophthalmol, 2015, 159(3):512-518.DOI:10.1016/j.ajo.2014.11.034.
23.	Lee EJ, Kim TW, Weinreb RN, et al.Lamina cribrosa thickness is not correlated with central corneal thickness or axial length in healthy eyes:central corneal thickness, axial length, and lamina cribrosa thickness[J].Graefe's Arch Clin Exp Ophthalmol, 2013, 251(3):847-854. DOI:10.1007/s00417-012-2145-y.
24.	Jonas JB, Berenshtein E, Holbach L.Lamina cribrosa thickness and spatial relationships between intraocular space and cerebrospinal fluid space in highly myopic eyes[J]. Invest Ophthalmol Vis Sci, 2004, 45(8):2660-2665.
25.	Erichev VP, Mazurova YV, Dan T.Centrally acting cholinominetics in the complex therapy of progressive glaucomatous optic neuropathy[J].Vestn Oftalmol, 2016, 132(2):33-37.
26.	Pache M. Primary open-angle glaucoma and systemic diseases[J]. Ophthalmologe, 2007, 104(5):431-441.

1. Quigley HA, Addicks EM, Green WR, et al. Optic nerve damage in human glaucoma. Ⅱ. The site of injury and susceptibility to damage[J]. Arch Ophthalmol, 1981, 99(4):635-649.
2. Quigley HA, Hohman RM, Addicks EM, et al. Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma[J].Am J Ophthalmol, 1983, 95(5):673-691.
3. Lee EJ, Kim TW, Weinreb RN, et al. Visualization of the lamina cribrosa using enhanced depth imaging spectral-domain optical coherence tomography[J].Am J Ophthalmol, 2011, 152(1):87-95. DOI:10.1016/j.ajo.2011.01.024.
4. Park SC, Ritch R. High resolution in vivo imaging of the lamina cribrosa[J]. Saudi J Ophthalmol, 2011, 25(4):363-372. DOI:10.1016/j.sjopt.2011.07.007.
5. Emery JM, Landis D, Paton D, et al. The lamina cribrosa in normal and glaucomatous human eyes[J]. Trans Am Acad Ophthalmol Otolaryngol, 1974, 78(2):290-297.
6. Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J]. Am J Ophthalmol, 2015, 159(3):512-518. DOI:10.1016/j.ajo.2014.11.034.
7. Furlanetto RL, Park SC, Damle UJ, et al. Posterior displacement of the lamina cribrosa in glaucoma:in vivo interindividual and intereye comparisons[J].Invest Ophthalmol Vis Sci, 2013, 54(7):4836-4842. DOI:10.1016/iovs.12-11530.
8. Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J]. Am J Ophthalmol, 2015, 159(3):512-518. DOI:10.1016/j.ajo.2014.11.034.
9. Faridi OS, Park SC, Kabadi R, et al. Effect of focal lamina cribrosa defect on glaucomatous visual field progression[J]. Ophthalmology, 2014, 121(8):1524-1530. DOI:10.1016/j.ophtha.2014.02.017.
10. Quigley HA, Katz J, Derick RJ, et al. An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage[J]. Ophthalmology, 1992, 99(1):19-28.
11. Howell GR, Libby RT, Jakobs TC, et al. Axons of retinal ganglion cells are insulted in the optic nerve early in DBA/2J glaucoma[J].J Cell Biol, 2007, 179(7):1523-1537.
12. Buckingham BP, Inman DM, Lambert W, et al. Progressive ganglion cell degeneration precedes neuronal loss in a mouse model of glaucoma[J]. J Neurosci, 2008, 28(11):2735-2744.DOI:10.1523/JNEUROSCI.4443-07.2008.
13. Harwerth RS, Carter-Dawson L, Shen F, et al. Ganglion cell losses underlying visual field defects from experimental glaucoma[J].Invest Ophthalmol Vis Sci, 1999, 40(10):2242-2250.
14. Burgoyne CF, Downs JC, Bellezza AJ, et al. The optic nerve head as a biomechanical structure:a new paradigm for understanding the role of IOP-related stress and strain in the pathophysiology of glaucomatous optic nerve head damage[J].Prog Retin Eye Res, 2005, 24(1):39-73.
15. Shrout PE. Measurement reliability and agreement in psychiatry[J]. Stat Methods Med Res, 1998, 7(3):301-317.
16. Park HY, Jeon SH, Park CK. Enhanced depth imaging detects lamina cribrosa thickness differences in normal tension glaucoma and primary open angle glaucoma[J]. Ophthalmology, 2012, 119(1):10-20. DOI:10.1016/j.ophtha.2011.07.033.
17. Ren R, Wang N, Li B, et al. Lamina cribrosa and peripapillary sclera histomorphometry in normal and advanced glaucomatous Chinese eyes with various axial length[J].Invest Ophthalmol Vis Sci, 2009, 50(5):2175-2184.DOI:10.1167/iovs.07-1429.
18. Jung KI, Jung Y, Park KT, et al.Factors affecting plastic lamina cribrosa displacement in glaucoma patients[J].Invest Ophthalmol Vis Sci, 2014, 55(12):7709-7715. DOI:10.1167/iovs. 14-13957.
19. Lee EJ, Kim TW, Weinreb RN. Reversal of lamina cribrosa displacement and thickness after trabeculectomy in glaucoma[J].Ophthalmology, 2012, 119(7):1359-1366. DOI:10. 1016/j.ophtha. 2012.01.034.
20. Park SC, Brumm J, Furlanetto RL, et al. Lamina cribrosa depth in different stages of glaucoma[J].Invest Ophthalmol Vis Sci, 2015, 56(3):2059-2064. DOI:10.1167/iovs. 14-15540.
21. Furlanetto RL, Park SC, Damle UJ, et al.Posterior displacement of the lamina cribrosa in glaucoma:in vivo interindividual and intereye comparisons[J].Invest Ophthalmol Vis Sci, 2013, 54(7):4836-4842. DOI:10.1167/iovs.12-11530.
22. Kwun Y, Han JC, Kee C. Comparison of lamina cribrosa thickness in normal tension glaucoma patients with unilateral visual field defect[J].Am J Ophthalmol, 2015, 159(3):512-518.DOI:10.1016/j.ajo.2014.11.034.
23. Lee EJ, Kim TW, Weinreb RN, et al.Lamina cribrosa thickness is not correlated with central corneal thickness or axial length in healthy eyes:central corneal thickness, axial length, and lamina cribrosa thickness[J].Graefe's Arch Clin Exp Ophthalmol, 2013, 251(3):847-854. DOI:10.1007/s00417-012-2145-y.
24. Jonas JB, Berenshtein E, Holbach L.Lamina cribrosa thickness and spatial relationships between intraocular space and cerebrospinal fluid space in highly myopic eyes[J]. Invest Ophthalmol Vis Sci, 2004, 45(8):2660-2665.
25. Erichev VP, Mazurova YV, Dan T.Centrally acting cholinominetics in the complex therapy of progressive glaucomatous optic neuropathy[J].Vestn Oftalmol, 2016, 132(2):33-37.
26. Pache M. Primary open-angle glaucoma and systemic diseases[J]. Ophthalmologe, 2007, 104(5):431-441.

Chinese Journal of Ocular Fundus Diseases

Comparing the lamina cribrosa in eyes with primary open angle glaucoma and chronic primary angle closure glaucoma

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