Abstract

To measure laminar and peripapillary scleral architecture in normal and glaucomatous Chinese eyes with normal and those with elongated axial length. The histomorphometric investigation included a normal group (nonaxially elongated eyes) of 40 human globes (40 patients; mean age, 41.3 +/- 13.4 years; range,15-68) enucleated because of malignant choroidal melanoma, a glaucomatous group (non-axially elongated eyes) of 55 eyes (55 patients; age, 43.3 +/- 20.3 years; range, 12-88) enucleated because of painful secondary angle-closure glaucoma, and a group of 26 glaucomatous globes (glaucomatous elongated axial length group; 26 patients; age, 29.0 +/- 14.4 years; range, 12-60) with an axial length > 27.5 mm. Anterior-posterior histologic sections were morphometrically evaluated. The lamina cribrosa was significantly (P < 0.001) thicker in the normal group than in the glaucomatous group, in which it was significantly (P < 0.001) thicker than in the glaucomatous elongated-length group. Lamina cribrosa thickness decreased significantly with increasing axial length (P < 0.001) and presence of glaucoma (P < 0.001). Peripapillary scleral thickness close to the optic nerve scleral canal and just outside of the optic nerve meninges decreased significantly with increasing axial length (P = 0.04 and P = 0.02, respectively). Peripapillary scleral thickness did not vary significantly between the glaucomatous group and the normal group. The distance between the intraocular space and cerebrospinal fluid space was (P < 0.001) shorter in the two glaucomatous groups than in the normal group. Lamina cribrosa thickness and peripapillary sclera thickness decreased significantly with axial length, in addition to a glaucoma-related thinning of the lamina cribrosa. In non-axially elongated eyes, the peripapillary sclera thickness did not vary significantly between glaucomatous eyes and normal eyes.

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