Título

WHICH LAMINAR PARAMETER BETTER CORRELATES WITH STRUCTURAL DAMAGE IN GLAUCOMA? AN EDI-OCT ANALYSIS OF THICKNESS AND DEPTH

Objetivo

We sought to investigate which lamina cribrosa (LC) parameter (anterior LC depth [ALD] or LC thickness [LCT]) better correlates with structural damage in glaucoma.

Método

We prospectively enrolled healthy participants and glaucomatous patients with a wide range of disease stage. All patients underwent visual field (VF) testing and EDI OCT imaging. The following optic nerve head parameters were measured on serial vertical B-scans by 2 experienced examiners masked to patient’s clinical data: ALD, LCT and BMO-MRW. Peripapillary retinal nerve fiber layer (pRNFL) thickness values were also obtained. Only good quality images were considered. Whenever both eyes were eligible, only one was randomly selected for analysis. We investigated the correlations between LC parameters (LCT and ALD) and structural metrics (pRNFL and BMO-MRW) adjusting for possible confounding factors.

Resultado

A total of 73 participants (39 with glaucoma and 34 controls) were included. Mean VFMD index for glaucomatous eyes was -9.4±7.4dB. Mean age, intraocular pressure and axial length did not differ significantly between glaucomatous eyes and controls (p≥0.122). Both ALD and LCT differed significantly between glaucomatous eyes and controls (p≤0.032, table 1). LCT was significantly correlated with both structural parameters (pRNFL: r=0.279; BMO-MRW: r=0.336; p≤0.049). There were no significant correlations between ALD and none of the structural parameters evaluated (p≥0.430). Secondary analysis revealed that ALD values were significantly influenced by other ocular parameters, such as axial length (r=0.277) and LCT (r=-0.310; p≤0.042).

Conclusão

Our results suggest that LCT, but not ALD, is significantly associated with structural damage in eyes with glaucoma. Eyes with thinner LC have worse structural loss. Although ALD differs between eyes with and without glaucoma, other factors rather than disease stage seem to be associated with it.