Abstract
Objectives:To calculate the anterior lamina cribrosa depth (ALCD) and lamina cribrosa thickness (LCT) in primary open angle glaucoma (POAG) patients and controls and to correlate lamina cribrosa (LC) parameters to retinal nerve fiber layer thickness (RNFLT) and visual field (VF) defects.Methods:The study was conducted from November 2018 to March 2019. A total of 60 correspondents (30 cases and 30 controls) were assessed for general ophthalmological investigations including intraocular pressure (IOP), axial length AXL, ophthalmoscopy, visual field (VF) testing and spectral domain ocular computed tomography (SDOCT).Results:The mean age of subjects was 62 years (Cases 67.30±1.2, controls 57.32±1.1) with more male participants. Intraocular pressure [IOP (19.85 ±1.4)], AXL (22.85 ± 1.6), VF defects (8.30 ± 4.5), RNFLT (72.58 ± 13.2) and LCT (162.51 ± 64.62) were statistically significant in POAG patients as compared to the controls.Conclusion:A thinner LC in POAG correlated significantly with the RNFLT and VF defects. LC anatomical parameters can be estimated with precision using SDOCT with enhanced depth imaging (EDI).
Highlights
Spectrum of glaucoma includes diverse ocular disorders
No difference was found in the age or gender of the respondents whereas AXL, intraocular pressure (IOP), PSD and retinal nerve fiber layer thickness (RNFLT) were significantly higher in Primary open-angle glaucoma (POAG) groups as compared to the controls (Table-I)
Increase in the severity of IOP, AXL, vertical cup-to-disc ratio (VCDR) and PSD with decreased RNFLT and Lamina cribrosa (LC) thickness (LCT) produced statistically significant results in cases compared to controls
Summary
Spectrum of glaucoma includes diverse ocular disorders. All types have in common chronic glaucomatous optic neuropathy (GON) accompanied by optic nerve head (ONH) surface anatomical derangements, neuroretinal rim (NRR) thinning and alterations of the retinal nerve fiber layer (RNFL) culminating in typical visual field defects(VF).[1]. LC deformations have clinically been proven to precede early RNFL thinning,[4] its in-vivo imaging merit significance. Studies have proved glaucomatous LC to be thinner and deeper in comparison to normal eyes.[5] Greater the magnitude of LCD and LCT, the more severe RNFL thinning and subsequent VF defects may be conjectured, measurements of these novel LC markers merits clinical attention and highlight the structure-function relationship. First time in Pakistan we assessed the LCD and LCT using EDI-SDOCT and correlated the LC structure with RNFL thickness and VF defects in POAG and normal subjects which we trust can prove as a beneficial prophylactic measure against the devastating blindness caused by glaucoma
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