Laminar displacement and prelaminar tissue thickness change after glaucoma surgery imaged with optical coherence tomography

To study changes in lamina cribrosa position and prelaminar tissue thickness (PTT) after surgical IOP reduction in glaucoma patients. Twenty-two patients (mean age, 71.4 years) were imaged with spectral domain optical coherence tomography (SD-OCT; 24 radial B-scans centered on the optic nerve head [...

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Bibliographic Details
Published in:	Investigative ophthalmology & visual science Vol. 53; no. 9; pp. 5819 - 5826
Main Authors:	Reis, Alexandre S C, O'Leary, Neil, Stanfield, Miriam J, Shuba, Lesya M, Nicolela, Marcelo T, Chauhan, Balwantray C
Format:	Journal Article
Language:	English
Published:	United States 24-08-2012
Subjects:	Aged Aged, 80 and over Female Glaucoma Drainage Implants Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Gonioscopy Humans Imaging, Three-Dimensional Intraocular Pressure - physiology Male Middle Aged Optic Disk - pathology Optic Nerve Diseases - physiopathology Prospective Studies Tomography, Optical Coherence Tonometry, Ocular Trabeculectomy Visual Acuity - physiology Visual Fields - physiology
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Summary:	To study changes in lamina cribrosa position and prelaminar tissue thickness (PTT) after surgical IOP reduction in glaucoma patients. Twenty-two patients (mean age, 71.4 years) were imaged with spectral domain optical coherence tomography (SD-OCT; 24 radial B-scans centered on the optic nerve head [ONH]) before trabeculectomy or tube shunt implantation. Follow up images were acquired 1 week, 1 month, 3 months, and 6 months postsurgery. Bruch's membrane opening (BMO), the internal limiting membrane (ILM) and the anterior laminar surface (ALS) were segmented in each radial scan with custom software. Surfaces were fitted to the ILM and ALS with the extracted three-dimesional coordinates. PTT was the distance between the ILM and ALS, perpendicular to a BMO reference plane. Serial postsurgical laminar displacement (LD), relative to the BMO reference plane, and changes in PTT were measured. Positive values indicated anterior LD. Mean (SD) presurgery IOP was 18.1 (6.5) mm Hg, and reduced by 4.7 (5.5), 2.4 (7.7), 7.0 (6.2), and 6.8 (7.5) mm Hg at 1 week, 1 month, 3 months, and 6 months postsurgery, respectively. At the four postsurgery time points, there was significant anterior LD (1.8 [9.5], -1.1 [8.9], 8.8 [20.2], and 17.9 [25.8] μm) and PTT increase (1.7 [13.3], 2.4 [11.9], 17.4 [13.7], and 13.9 [18.6] μm). LD was greater in ONHs with larger BMO area (P = 0.01) and deeper ALS (P = 0.04); however, PTT was not associated with any of the tested independent variables. Both anterior LD and thickening of prelaminar tissue occur after surgical IOP reduction in patients with glaucoma.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1552-5783 1552-5783
DOI:	10.1167/iovs.12-9924