Research advances in structure and imaging of lamina cribrosa

Abstract

The lamina cribrosa(LC) is a reticulated, sieve-like structure, which unmyelinated retinal ganglion cell (RGC) axons pass through. The LC has long been identified as the main site of RGC axonal injury and hence important in the pathogenesis of glaucoma. Improvements in imaging such as optical coherence tomography(OCT) image capture and image processing have allowed detailed of LC macro-biomechanical and micro-architectural characteristics. In this review, we first aim to frame the biomechanical considerations of lamina cribrosa in a clinical context and to discuss the concept of the translaminar pressure gradient (TLPD). At the same time, we aim to highlight the technological advances in imaging the LC and its accompanying clinical implications, and future research directions in this field. In addition to the changes in intraocular pressure, cerebrospinal fluid pressure (CSFP) and TLPD play an important role in the pathogenesis of glaucoma. The displacement direction of the LC effects not only on the mechanical stress change caused by TLPD, but also included the biomechanical properties of the surrounding scleral structure. Scotoma in the glaucoma patient’s is associated with local damage, defects or remodeling of the LC. However, the anterior surface parameters of OCT imaging including LC depth (LCD), LC curvature (LCC) and LC global shape index (LC-GSI) were also correlated with the occurrence and progression of glaucoma.(Int Rev Ophthalmol, 2019, 43: 300-305) Key words: glaucoma; lamina cribrosa; optical coherence tomography; translaminar pressure difference