Comparison between Lamina Cribrosa Depth and Curvature as a Predictor of Progressive Retinal Nerve Fiber Layer Thinning in Primary Open-Angle Glaucoma

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Comparison between Lamina Cribrosa Depth and Curvature as a Predictor of Progressive Retinal Nerve Fiber Layer Thinning in Primary Open-Angle Glaucoma Eun Ji Lee, MD, Tae-Woo Kim, MD, Hyunjoong Kim, PhD, Seung Hyen Lee, MD, Michaël J.A. Girard, PhD, Jean Martial Mari, PhD Ophthalmology Glaucoma Volume 1, Issue 1, Pages 44-51 (July 2018) DOI: 10.1016/j.ogla.2018.05.007 Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 1 Measurements of lamina cribrosa (LC) deformation. A, Infrared image of an optic nerve head (ONH) showing the 7 locations at which the measurements were performed (horizontal lines). B, Enhanced depth image of plane 6 (A, light green line) processed by adaptive compensation. C, The same image as in (B), showing the measurement of LC depth (LCD) from Bruch’s membrane (LCD-BM, red double headed arrows) and from the anterior sclera (LCD-AS, light green double-headed arrows). Red and light green lines indicate the BM and AS reference planes, respectively, which were determined 800 μm (dashed lines) from the BM termination point (red glyphs). D, The same image as in (B), showing the determination of LC curvature index (LCCI), which was measured by dividing the LC curve depth (double headed arrow) within the BM opening (red glyphs and dashed lines) by the BM opening width (W) and then multiplying by 100. Ophthalmology Glaucoma 2018 1, 44-51DOI: (10.1016/j.ogla.2018.05.007) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 2 Scatterplots showing the relationships among the rates of global (A–C), temporal-superior (D–F), and temporal-inferior (G–I) retinal nerve fiber layer (RNFL) thinning and lamina cribrosa (LC) depth (LCD) from Bruch’s membrane (BM) (A, D, G), LCD anterior sclera (AS) (B, E, H), and LCCI (C, F, I). An asterisk indicates a significantly higher correlation than that of LCD-BM. Double asterisks indicate significantly higher correlations than those of both LCD-BM and LCD-AS. LCCI = lamina cribrosa curvature index; TI = temporal-inferior; TS = temporal-superior. Ophthalmology Glaucoma 2018 1, 44-51DOI: (10.1016/j.ogla.2018.05.007) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 3 A glaucomatous eye showing progression at the location of greater lamina cribrosa (LC) curvature. A, Infrared image showing the locations at which the enhanced-depth images (B–E) were obtained. Enhanced-depth images in the superior (B, C) and inferior midperiphery (D, E) processed by adaptive compensation, showing greater LC curvature in the inferior (E) than in the superior (C) sector (yellow lines). In contrast, lamina cribrosa depth (LCD) measured from the level of Bruch’s membrane (BM) (green lines) or the anterior sclera (AS) (red lines) does not differ noticeably between the inferior and superior regions. F, Note that the rate of retinal nerve fiber layer (RNFL) thinning is greater in the temporal-inferior (TI) than in the temporal-superior (TS) sector. G, Progressive RNFL thinning in the TI sector on serial OCT examination. H, Progressive visual field defect in the superior hemifield on standard automated perimetry. G = global; GHT = Glaucoma Hemifield Test; MD = mean deviation; PSD = pattern standard deviation; VFI = visual field index. Ophthalmology Glaucoma 2018 1, 44-51DOI: (10.1016/j.ogla.2018.05.007) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions