Reversal of Lamina Cribrosa Displacement after Intraocular Pressure Reduction in Open-Angle Glaucoma

• Published in: Ophthalmology (Rochester, Minn.) Vol. 120; no. 3; pp. 553 - 559
• Main Authors: Lee, Eun Ji, MD, Kim, Tae-Woo, MD, Weinreb, Robert N., MD, Kim, Hyunjoong, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Female; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Gonioscopy; Humans; Intraocular Pressure - physiology; Male; Middle Aged; Ophthalmology; Optic Disk - physiopathology; Optic Nerve Diseases - physiopathology; Tomography, Optical Coherence; Tonometry, Ocular; Trabeculectomy; Visual Acuity - physiology; Visual Field Tests; Visual Fields; Young Adult
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/j.ophtha.2012.08.047

Purpose 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). Design Observational case series. Participants 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. Methods 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. Main Outcome Measures The mean and maximum amount of reductions in LC depth measured in the 7 selected B-scan images. Results 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). Conclusions 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. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.