Location of the Central Retinal Vessel Trunk in the Laminar and Prelaminar Tissue of Healthy and Glaucomatous Eyes

Bo Wang,Chen Lu,Joel S Schuman,Larry Kagemann,Gadi Wollstein,Richard A Bilonick,Hiroshi Ishikawa,Ian A Sigal,James G Fujimoto,Katie A Lucy

doi:10.1038/s41598-017-10042-5

Abstract

Glaucoma is a leading cause of blindness that leads to characteristic changes in the optic nerve head (ONH) region, such as nasalization of vessels. It is unknown whether the spatial location of this vessel shift inside the ONH occurs within the lamina cribrosa (LC) or the prelaminar tissue. The purpose of this study was to compare the location of the central retinal vessel trunk (CRVT) in the LC and prelaminar tissue in living healthy and glaucomatous eyes. We acquired 3-dimensional ONH scans from 119 eyes (40 healthy, 29 glaucoma suspect, and 50 glaucoma) using optical coherence tomography (OCT). The CRVT location was manually delineated in separate projection images of the LC and prelamina. We found that the CRVT in glaucoma suspect and glaucomatous eyes was located significantly more nasally compared to healthy eyes at the level of the prelamina. There was no detectable difference found in the location of the CRVT at the level of the LC between diagnostic groups. While the nasal location of the CRVT in the prelamina has been associated with glaucomatous axonal death, our results suggest that the CRVT in the LC is anchored in the tissue with minimal variation in glaucomatous eyes.

Highlights

Glaucoma is a leading cause of blindness that leads to characteristic changes in the optic nerve head (ONH) region, such as nasalization of vessels
It is unknown whether the spatial location of this vessel shift inside the ONH occurs within the lamina cribrosa (LC) or the prelaminar tissue
We found that the central retinal vessel trunk (CRVT) in glaucoma suspect and glaucomatous eyes was located significantly more nasally compared to healthy eyes at the level of the prelamina

Summary

Introduction

Glaucoma is a leading cause of blindness that leads to characteristic changes in the optic nerve head (ONH) region, such as nasalization of vessels. The second leading cause of blindness worldwide, is an optic neuropathy resulting in vision loss due to the death of retinal ganglion cell axons[1] Axonal death results in characteristic changes that occur at the level of the optic nerve and retina[2, 3]. These changes include a shift of the central retinal vessels, often nasally, which has been observed clinically and experimentally in glaucomatous eyes[4,5,6] and can be used to characterize abnormal glaucomatous discs. The purpose of this study was to test the hypothesis that the retinal vessel shift seen in glaucoma occurs at the level of the prelaminar tissue

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