Abstract

To compare optic nerve head (ONH) morphology of optic nerve atrophy between eyes with primary open-angle glaucoma (POAG) and eyes with a history of nonarteritic anterior ischemic optic atrophy (NAION) using enhanced depth imaging (EDI) with spectral-domain optical coherence tomography (SD-OCT). In this cross-sectional study, 121 eyes of 91 patients consisted of moderate to severe POAG (n = 32 eyes), visual field mean deviation-matched NAION (n = 30 eyes) and their fellow eyes (n = 30 eyes), and healthy controls (n = 29). The optic discs were scanned using SD-OCT and measurements were obtained using HEYEX software 6.0. Lamina cribrosa (LC) thickness and anterior lamina cribrosa depth (ALD) at three scans (midsuperior, central, and midinferior) were determined and compared. In addition, prelaminar tissue thickness was measured at three points of a single central scan. There was no significant difference in the visual field mean deviation (MD) between the NAION and POAG groups (P > 0.99), but both groups had a significantly worse MD than the healthy group (P < 0.001). The NAION and POAG groups had similar peripapillary retinal nerve fiber layer (pRNFL) thickness (P < 0.99). Eyes with POAG had greater ALD and thinner LC than control eyes and NAION eyes in all regions of the ONH (P < 0.001 for both). There was a marked prelaminar tissue thinning in POAG eyes compared to control and NAION eyes (P < 0.001). Lamina cribrosa thickness and ALD of NAION eyes were not different from their fellow eyes and control eyes. Although prelaminar thickness was thinner in NAION eyes compared to their fellow eyes (P = 0.005), it was thicker than in control eyes (P < 0.001). Despite profound thinning and posterior displacement of LC in POAG, the thickness and position of LC in NAION eyes are similar to those seen in healthy control and their fellow eyes.

Highlights

  • Despite profound thinning and posterior displacement of Lamina cribrosa (LC) in primary open-angle glaucoma (POAG), the thickness and position of LC in nonarteritic anterior ischemic optic neuropathy (NAION) eyes are similar to those seen in healthy control and their fellow eyes

  • In contrast to NAION, which presents with disc pallor after an ischemic event, open-angle glaucoma (OAG) results in the enlargement of the optic disc cup.[2]

  • Optic nerve head (ONH) morphologic features differ in NAION and OAG

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Summary

Methods

In this cross-sectional study, 121 eyes of 91 patients consisted of moderate to severe POAG (n 1⁄4 32 eyes), visual field mean deviation–matched NAION (n 1⁄4 30 eyes) and their fellow eyes (n 1⁄4 30 eyes), and healthy controls (n 1⁄4 29). Patients with moderate to severe POAG and visual field mean deviation (MD)-matched chronic unilateral NAION, as well as healthy control subjects who visited the outpatient clinic of Farabi Eye Hospital between July 2014 and March 2015, were enrolled in this cross-sectional study. A linear mixed model was used to compare the ONH parameters among groups along with Bonferroni correction to account for multiple comparisons. To simultaneously compare ONH parameters between POAG and NAION groups with statistical correction for age, sex, axial length, and pRNFL, multivariate analysis of covariance (MANCOVA) was performed. A P value less than 0.05 was considered statistically significant

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