Abstract
PurposeTo develop a method to quantify, based on swept-source optical coherence tomography (OCT), the 3D structure of the laminar pores in patients with glaucoma.MethodsThis retrospective study examined 160 laminar pores from 8 eyes of 8 cases: 4 normal subjects and 4 open-angle glaucoma (OAG) patients. We reconstructed 3D volume data for a 3 x 3 mm disc, using a method similar to OCT angiography, and segmented the structure of the lamina cribrosa. Then, we manually segmented each laminar pore in sequential C-scan images (>90 slices at 2.6-micron intervals) with VCAT5 (RIKEN, Japan). We compared the control and OAG subjects with the Mann-Whitney U test. Differences were considered significant at p < 0.05.ResultsWe found that the laminar pores of the OAG patients had a significantly smaller average cross-sectional area, smaller 3D volume (adjusted to the average thickness of the lamina cribrosa), and higher true sphericity, and lower principal value (P1, 2, 3) of the 3D structure data (all: p < 0.0001). The topographic distribution of damaged laminar pores was consistent with the damaged area of the macular map.ConclusionWe successfully developed a method to quantify the 3D structure of the laminar pores; providing a useful tool to assess lamina cribrosa-associated risk factors for glaucoma. These findings promise to benefit future investigations into the pathomechanisms of glaucoma.
Highlights
We found that the laminar pores of the open-angle glaucoma (OAG) patients had a significantly smaller average cross-sectional area, smaller 3D volume, and higher true sphericity, and lower principal value (P1, 2, 3) of the 3D structure data
optical coherence tomography (OCT)-measured laminar pores in glaucoma supported in part by JST grants from JSPS KAKENHI Grants-in-Aid for Scientific Research (B) (T.N. 17H04349) and for Exploratory Research
We successfully developed a method to quantify the 3D structure of the laminar pores; providing a useful tool to assess lamina cribrosa-associated risk factors for glaucoma
Summary
Intraocular pressure (IOP) is the most important treatable risk factor for glaucoma, but many non-IOP risk factors have been reported to contribute to glaucoma pathogenesis, including age [1, 2], myopia [2, 3], family history [4], abnormalities in the lamina cribrosa (LC) [5], low ocular perfusion pressure [6, 7], oxidative stress [8], inflammation [9], and lifestyle [5, 10]. We previously reported that thinning of the LC was already detectible in preperimetric glaucoma, and that decreased LC thickness was independently associated with the severity of glaucoma, cupping formation in the optic disc, and tissue blood flow in the ONH [17]. Taken together, these findings suggest that axonal damage in the LC plays a major role in glaucoma, and that LC thickness promises to be a biomarker of glaucoma, and a source of new insights into the pathogenesis of glaucoma
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