Association of Bergmeister Papilla and Deep Optic Nerve Head Structures With Prelaminar Schisis of Normal and Glaucomatous Eyes

Abstract

To investigate factors associated with the severity of prelaminar schisis (PLS) in heathy subjects and glaucoma patients. Prospective cross-sectional study METHODS: Two hundred seventeen eyes of 217 subjects (110 normal eyes and 107 open angle glaucoma eyes). Frequency and severity of PLS were compared between normal and glaucomatous eyes. Multivariate logistic models were used to assess factors associated with the severity of PLS. Factors considered were age, axial length, glaucomatous damage indices, Bruch's membrane opening (BMO) and anterior scleral canal opening parameters, tractional forces (posterior vitreous staging and the presence of Bergmeister's papilla), circumpapillary choroidal thickness, lamina cribrosa (LC) parameters and peripapillary scleral (PPS) angle. The frequency of PLS was 70.9% in normal eyes and 72.0% in glaucomatous eyes. There was no difference in frequency and severity between the groups. The presence of Bergmeister's papilla was the strongest predictor of a more severe PLS in both normal and glaucomatous eyes (OR: 9.78, 12.5; both p<0.001). A larger PPS angle in normal eyes (OR:1.19; p=0.003) and a larger BMO area and a deeper LC depth in glaucomatous eyes (OR: 1.08, 1.05; both p=0.038) were associated with severity of PLS. The severity of PLS was strongly associated with the presence of Bergmeister's papilla suggesting a traction-related phenomenon. Correlation of PLS severity with larger BMO area and deeper LC depth, which are ONH structures associated with glaucoma, suggested its possible relationship with glaucomatous damage.