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Lamina cribrosa defects may be biomarkers of glaucoma in myopic eyes
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Researchers found a strong correlation of disinsertion type lamina cribrosa defects with glaucoma and parameters related to myopia, in a study from Investigative Ophthalmology and Visual Science.
Han and colleagues used enhanced depth imaging spectral domain optical coherence tomography to study the structural characteristics of lamina cribrosa in myopic eyes with and without open-angle glaucoma (OAG).
Defects in the lamina cribrosa (LC) were found more in myopic eyes with OAG.
Disinsertion-type LC defects were found at the location of the -zone peripapillary atrophy, according to researchers.
Complete detachment-type defects predominated in myopic eyes with OAG, while triangular wedge-type defects were more common in myopic eyes without OAG.
Myopic eyes show significantly different axial length, spherical equivalent and BM opening area compared to the normal eyes without myopia, according to the study.
Maximal peripapillary atrophy length and disc tilt angle were larger in myopic eyes with than without OAG.
Researchers found LC defects in myopic eyes, even in those without OAG; however, the defects were more frequent in myopic eyes with OAG. Multiple LC defects were also noted more often in myopic eyes with than without OAG.
The LC disinsertion size was larger in myopic eyes with OAG; complete detachment was found more frequently in myopic eyes with OAG, and triangular wedge-type defects were mostly seen in myopic eyes without OAG, the researchers stated.
“Therefore, the disinsertion-type LC defects are considered as one of the possible biomarkers of glaucoma in myopic eyes,” they concluded. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
Glaucoma is a complex, multifactorial disease, with myopia increasing glaucoma risk twofold. Although considered by most to be a “soft” risk factor, myopia seems to play a larger role in glaucoma development and progression for certain individuals. Identifying these individuals from our large pool of at-risk myopic patients would be of great value.
Han and colleagues utilized enhanced depth imaging (EDI) OCT technology to determine specific anatomic defects associated with glaucoma in myopic patients. Although all myopes had a higher frequency of lamina defects, they found a particular type of defect (the disinsertion type) was more highly correlated with glaucoma. The authors suggest that EDI OCT might be helpful in identifying a structural glaucoma biomarker.
I’ve been a somewhat vocal dissenter of OCT technology in glaucoma. I do obtain scans on all glaucoma patients but, although an important consideration, I rarely make clinical decisions based on OCT data alone. Ganglion cell analysis has been a helpful and promising development.
Although it is early in the use of EDI OCT for lamina analysis, this is another exciting application of OCT technology that may benefit not only the research realm, but clinical practice as well.
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