Relationship Between Anterior Lamina Cribrosa Surface Tilt and Glaucoma Development in Myopic Eyes.

PURPOSE: To evaluate the anterior lamina cribrosa (LC) surface tilt angle in myopic eyes and associate it with glaucoma development.

MATERIALS AND

METHODS

In this retrospective study, medical records of myopic patients referred for glaucoma examination from July 1, 2012 to March 30, 2016 were reviewed. Comprehensive ophthalmic examination including spectral-domain optical coherence tomography were performed. We measured the angle of anterior LC surface tilt against Bruch's membrane opening from optical coherence tomography images at the center of the clinical optic disc margin. In horizontal and vertical sections, the angles were defined as α and β, respectively. Patients were grouped according to the presence of glaucomatous damage and factors including optic nerve head morphologic parameters and LC tilt angles were compared between the 2 groups.

RESULTS

Among 138 patients originally enrolled, 102 patients were finally analyzed. One eye from 1 patient was randomly chosen. Fifty-five eyes had glaucoma and 47 were normal. The degree of myopia and all optic nerve head morphologic parameters were not significantly different between the 2 groups. However, |α| and |β| were significantly larger in the glaucoma group (all P<0.001), and significances were maintained in multivariate analysis (P<0.001).

CONCLUSIONS

Larger anterior LC surface tilt angles were related to the presence of glaucoma in normal-pressure myopic eyes. Angulation of the LC against Bruch's membrane opening plane might be associated with increased glaucoma susceptibility in myopic eyes. Further investigations are warranted before clinical utilization of LC tilt as glaucoma susceptibility biomarker.