Dynamic of the Three-dimensional Microarchitecture of Lamina Cribrosa Pores using Optical Coherence Tomography.

PRCIS: We found a significant increase in lamina cribrosa (LC) pore length after surgical IOP reduction in patients with glaucoma. This change in the LC microarchitecture was correlated with changes in macroarchitectural parameters.

PURPOSE: To investigate the dynamic changes in LC three-dimensional microarchitecture following surgical IOP reduction.

METHODS

Ten eyes of 10 glaucoma patients were imaged with spectral domain optical coherence tomography (SD-OCT) before and one month after glaucoma surgery. The pre- and postoperative LC depth and the thickness of LC and prelaminar tissue were determined on a median vertical section of the optic nerve head. Laminar pores were traced using a semi-automatic segmentation software. Pore length, tortuosity and verticality were measured on the 3D reconstructions.

RESULTS

The intraocular pressure (IOP) decreased from 23.6±9.03 (mean±SD) to 11.3±3.68 mmHg at one month post-surgery (P<0.001). The mean LC depth was reduced from 571.8±125.6 to 419.9±96.0 μm (P=0.006). LC thickness increased significantly (228.8±29.27 preoperatively to 284.4±83.61 μm postoperatively (P=0.016)). No significant increase in the prelaminar tissue thickness was noted (132.7±42.46 preoperatively and 173.1±63.79 μm postoperatively (P=0.101)). In lamina 3D microarchitecture, pore length was significantly greater postoperatively (P=0.01). No significant difference was observed in tortuosity or verticality (P=0.912 and P=0.159 respectively).

CONCLUSIONS

We found a significant increase in LC pore length after glaucoma surgery using SD-OCT of the optic nerve head. Further studies are necessary to better characterize the dynamics of laminar microarchitecture and its influence on the prognosis of glaucomatous neuropathy.