Factors affecting plastic lamina cribrosa displacement in glaucoma patients.

Abstract

To investigate factors associated with irreversible components of anterior lamina cribrosa (LC) depth in glaucoma patients. A total of 141 glaucoma patients and 51 healthy control subjects were enrolled. The optic nerve head (ONH) was imaged using the enhanced depth imaging (EDI) modes of Spectralis optical coherence tomography (OCT). The depth of the LC was measured at the midhorizontal, superior, and inferior midperipheral regions of the ONH of each eye. Analyzed factors associated LC depth included age, axial length, intraocular pressure (IOP), disc size, central corneal thickness, average retinal nerve fiber layer (RNFL) thickness, and mean deviation (MD). In glaucoma patients, the LC was more deeply located compared with the control group at the midhorizontal and superior and inferior midperipheral B-scans (All P < 0.001). Age, initial IOP, and treated IOP was correlated with mean LC depth (All P < 0.001), and those correlations remained after adjusting for MD and RNFL thickness (All P < 0.001). In multivariate analysis, younger age, high untreated IOP, and thinner RNFL thickness was significantly associated with a deeper LC (P = 0.015, <0.001, and 0.042). There was an interaction between age and MD as predictors for LC depth (P = 0.007). The anterior LC surface is more deeply located in glaucoma patients compared with healthy controls. In glaucoma patients, age, initial IOP, and RNFL thickness were influential factors related to LC depth. These factors should be considered in clinical application of plastic LC displacement in glaucoma patients.