Korean J Ophthalmol.  2014 Dec;28(6):473-478. 10.3341/kjo.2014.28.6.473.

Comparison of the Thickness of the Lamina Cribrosa and Vascular Factors in Early Normal-tension Glaucoma with Low and High Intraocular Pressures

• Kim JH
• Lee TY
• Lee JW
• Lee KW

• KMID: 2345824
• DOI: http://doi.org/10.3341/kjo.2014.28.6.473

Abstract

PURPOSE
To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma.
METHODS
Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis).
RESULTS
The mean thickness of the central LC was 190.0 +/- 19.2 microm in the low IOP group and 197.8 +/- 23.6 microm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04).
CONCLUSIONS
The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG.

Keyword

Enhanced depth imaging method; Lamina cribrosa; Low tension glaucoma; Spectral domain optical coherence tomography

MeSH Terms

Aged
Cross-Sectional Studies
Female
Humans
*Intraocular Pressure
Low Tension Glaucoma/*diagnosis
Male
Middle Aged
Nerve Fibers/pathology
Optic Disk/*pathology
Optic Nerve Diseases/*diagnosis
Raynaud Disease/*diagnosis
Retinal Ganglion Cells/pathology
Tomography, Optical Coherence
Tonometry, Ocular
Vision Disorders/diagnosis
Visual Fields

Figure

• 

  Fig. 1 (A) Fundus photograph and (B,C) spectral-domain optical coherence tomography (OCT) images in the enhanced depth imaging (EDI) mode in a 78-year-old woman with normal-tension glaucoma. The mean intraocular pressure was 10 mmHg. In (A), the center of the optic nerve head (ONH) was identified at the point where the vertical center (line α) of the ONH met the horizontal center from which the trunk of the central retinal vessels came out from the ONH (line β). In (B), in the horizontal cross-sectional view of the EDI-OCT, the lamina cribrosa thickness (204 µm) was measured along line α, between lines β-1 and β-2. In (C), both the anterior and posterior borders (delineated with white arrows) of the lamina cribrosa were identified in the EDI-OCT.

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