Abstract
Elevated intraocular pressure (IOP) is one of the main risk factors for glaucoma, and pathological changes in the lamina cribrosa (LC) may play a leading role. This study aimed to explore the influence of different IOP on LC parameters and the correlation between parameters and glaucoma severity. A total of 91 eyes were examined by swept-source OCT and divided into IOP ≥ 30 mmHg (group A), 21 mmHg ≤ IOP < 30 mmHg (group B), and normal IOP (control, group C). Clinical parameters and all LC parameters such as cup depth (CD), lamina cribrosa depth (LCD), prelaminar tissue thickness (PTT) and LC curvature index (LCCI) were used for statistical analysis. The bulk of parameters were greater in group A than in the other groups (group B, P < 0.05; group C, P < 0.001). PTT and Bruch’s membrane opening minimum rim width (BMO-MRW) were thinner in group A than in group C (P < 0.01). In univariate and multivariable linear regression analysis, visual field (VF), mean retinal nerve fiber layer (RNFL) thickness, CD, LCD, PLCSD, PTT, LCCI, aLCCI, and BMO-MRW were significantly correlated with IOP changes (P < 0.05). Pearson test showed that LCD and LCCI were correlated with mean retinal nerve fiber layer (RNFL) thickness (LCD, r = − 0.420, P = 0.002; LCCI, r = − 0.449, P < 0.001) and BMO-MRW (LCD, r = − 0.245, P = 0.019; LCCI, r = − 0.345, P < 0.001). Therefore, different levels of IOP have a remarkable effect on clinical symptoms (VF, BCVA) and LC parameters, between which there may be a linear relationship. LCCI may exhibit a more significant correlation with RNFL thickness and BMO-MRW, which may further suggest that LCCI shows a better correlation with clinical symptoms under the influence of long-term high IOP.
Highlights
Elevated intraocular pressure (IOP) is one of the main risk factors for glaucoma, and pathological changes in the lamina cribrosa (LC) may play a leading role
To qualify for the study, POAG patients met the following criteria: glaucomatous optic disc changes, such as diffuse or localized notching, retinal nerve fiber layer (RNFL) defects in stereo disc photography, glaucomatous visual field (VF) defects corresponding to structural changes, and open angle confirmed by gonioscopic examination, were treated with medication for lower IOP (Beta Blockers, Adrenergic Agonists, Carbonic Anhydrase Inhibitors, etc.) but IOP maintained with a constant high level
After splitting different IOPs (IOP, 21, 25, 30, 35 mmHg), the results showed that even if any IOP level was taken as the boundary, there would be a correlation among lamina cribrosa depth (LCD), LC curvature index (LCCI) and the mean RNFL thickness with less than the boundary (P < 0.05) in the group, and the mean RNFL thickness would exhibit a correlation (r = − 0.263, P = 0.037) only when IOP was greater than 21 mmHg that LCD
Summary
Elevated intraocular pressure (IOP) is one of the main risk factors for glaucoma, and pathological changes in the lamina cribrosa (LC) may play a leading role. In univariate and multivariable linear regression analysis, visual field (VF), mean retinal nerve fiber layer (RNFL) thickness, CD, LCD, PLCSD, PTT, LCCI, aLCCI, and BMO-MRW were significantly correlated with IOP changes (P < 0.05). Abbreviations aLCCI Adjusted LCCI ALID Anterior laminar insertion depth AL Axial length BMO Bruch’s membrane opening BMO-MRW Bruch’s membrane opening minimum rim width CD Cup depth CV Cup volume CDR Cup/disk ratio EDI-OCT Enhanced depth imaging-OCT ILM Internal limiting membrane IOP Intraocular pressure LC Lamina cribrosa LCCI Lamina cribrosa curvature index LCD Lamina cribrosa depth LCT Lamina cribrosa thickness mALID Mean ALID. Regardless of the theory, post deformation of the LC is the basis of POAG10–13
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