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Lüke JN, Gietzelt C, Enders P, Dietlein J, Lappa A, Lüke V, Widder RA, Dietlein TS. Susceptibility of optic nerve head in children with posture-related elevation of intraocular pressure. Int Ophthalmol 2024; 44:182. [PMID: 38625418 PMCID: PMC11021221 DOI: 10.1007/s10792-024-03109-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND/AIMS This work aimed to investigate changes in optic nerve head (ONH) morphometry based on Bruch membrane opening in children with extensive nocturnal intraocular pressure (IOP) elevations. METHODS The course of Bruch membrane opening-based optic nerve head (ONH) morphometry was analysed in thirty-two patients younger than 18 years with evaluable SD-OCT examinations of the ONH and nocturnal posture-dependent IOP elevation above 25 mmHg. Longitudinal changes in neuroretinal rim tissue, as measured by Bruch Membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness, were assessed. RESULTS One year after the 24 h IOP measurement, global BMO-MRW (- 1.61 ± 16.8 µm, n.s.; p = 0.611) and RNFL (+ 0.64 ± 3.17 µm; n.s.; p = 0.292) measurements were not significantly different from the baseline. No significant BMO-MRW reduction (- 3.91 ± 24.3 µm; n.s. p = 0.458) or deviation in RNFL thickness (+ 1.10 ± 3.52 µm) was observed at the four-year follow-up. Absolute IOP values measured in the supine position did not correlate with changes in global BMO-MRW or RNFL thickness. CONCLUSION Posture-dependent IOP elevations do not seem to influence retinal nerve fibre layer thickness or Bruch membrane opening-based morphometric data in childhood.
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Affiliation(s)
- Jan Niklas Lüke
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Caroline Gietzelt
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Philip Enders
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Johanna Dietlein
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Alexandra Lappa
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Vincent Lüke
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Randolf Alexander Widder
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Gladbacher Str. 26, 40219, Düsseldorf, Germany
| | - Thomas S Dietlein
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Silveira VD, Lindenmeyer RL, Pakter HM, Skaat A, Lavinsky D, Oliveira M, Picceti E, Lavinsky J, de Arruda Mello PA, Lavinsky F. Optic Nerve Head Changes After Intraocular Pressure-Lowering Glaucoma Surgeries Using Optical Coherence Tomography. J Glaucoma 2023; 32:756-761. [PMID: 37311019 DOI: 10.1097/ijg.0000000000002242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/13/2023] [Indexed: 06/15/2023]
Abstract
PRCIS Optic nerve head (ONH) changes were detected with swept-source optical coherence tomography (SS-OCT) after intraocular pressure (IOP)-lowering glaucoma surgeries. PURPOSE The aim of this study was to detect changes in the ONH with SS-OCT after IOP-lowering procedures. PATIENTS AND METHODS Patients with progressing glaucoma who were referred for IOP-lowering procedures were included. The participants underwent a 24-2 visual field test and SS-OCT (DRI OCT Triton Plus; Topcon). IOP and SS-OCT scans were obtained during the preoperative period and up to 7 days and 30-90 days postoperatively. ONH parameters were measured with a B -scan at the center of the optic disc and an average of 5 central B -scans. The hypotenuse of the ONH cup (HOC) was calculated using the Pythagorean theorem: hypotenuse 2 = leg1 2 + leg2 2 , considering the length and depth of the cup as the legs of a right triangle. We also evaluated changes in Bruch membrane opening (BMO)-to-BMO diameter. Statistical analysis was performed using generalized estimating equations. RESULTS A total of 15 eyes were included. The mean patient age was 70 (SD, 11.04) years. The mean circumpapillary retinal nerve fiber layer was 60.13 (SD, 23.21) µm and the visual field mean deviation was -13.29 (SD, 8.5) dB. The mean IOP at each visit was: 20.5 (SD, 4.99); 11 (SD, 4.95), and 15.7 (SD, 5.04), respectively. The mean HOC, the mean depth and length of the ONH cup, and the BMO-to-BMO diameter decreased significantly after the IOP-lowering procedures. CONCLUSIONS The HOC evaluated with SS-OCT significantly decreased after IOP-lowering surgeries. This parameter was useful for evaluating short-term changes in the ONH.
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Affiliation(s)
| | | | - Helena Messinger Pakter
- Department of Ophthalmology, Hospital of Clinics from Porto Alegre, Porto Alegre, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alon Skaat
- Department of Ophthalmology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Lavinsky
- Department of Ophthalmology, Hospital of Clinics from Porto Alegre, Porto Alegre, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- GEPO (Group of Studies and Research in Ophthalmology), Lavinsky Eye Institute, Porto Alegre, Brazil
| | - Monica Oliveira
- Department of Ophthalmology, Hospital of Clinics from Porto Alegre, Porto Alegre, Brazil
| | - Egidio Picceti
- Department of Ophthalmology, Conceição Hospital Group, Porto Alegre, Brazil
| | - Jaco Lavinsky
- Department of Ophthalmology, Hospital of Clinics from Porto Alegre, Porto Alegre, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- GEPO (Group of Studies and Research in Ophthalmology), Lavinsky Eye Institute, Porto Alegre, Brazil
| | - Paulo Augusto de Arruda Mello
- Department of Ophthalmology, Paulista School of Medicine, Sao Paulo Hospital, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Fabio Lavinsky
- Department of Ophthalmology, Hospital of Clinics from Porto Alegre, Porto Alegre, Brazil
- GEPO (Group of Studies and Research in Ophthalmology), Lavinsky Eye Institute, Porto Alegre, Brazil
- Department of Ophthalmology, School of Medicine, Sinos River Valley University, São Leopoldo, Brazi
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Patel NB, Carter-Dawson L, Frishman LJ. Neuroretinal Rim Response to Transient Intraocular Pressure Challenge Predicts the Extent of Retinal Ganglion Cell Loss in Experimental Glaucoma. Invest Ophthalmol Vis Sci 2023; 64:30. [PMID: 37256608 PMCID: PMC10233313 DOI: 10.1167/iovs.64.5.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/12/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose To determine if the optic nerve head (ONH) response to transient elevated intraocular pressure (IOP) can predict the extent of neural loss in the nonhuman primate experimental glaucoma model. Methods The anterior chamber pressure of 21 healthy animals (5.4 ± 1.2 years, 8 female) was adjusted to 25 mm Hg for two hours followed by 10 mm Hg for an additional two hours. For the duration of IOP challenge the ONH was imaged using radial optical coherence tomography (OCT) scans at five-minute intervals. Afterward, a randomized sample of 14 of these subjects had unilateral experimental glaucoma induced and were monitored with OCT imaging, tonometry, and ocular biometry at two-week intervals. Results With pressure challenge, the maximum decrease in ONH minimum rim width (MRW) was 40 ± 10.5 µm at 25 mm Hg and was correlated with the precannulation MRW, Bruch's membrane opening (BMO) position, and the anterior lamina cribrosa surface position (P = 0.01). The maximum return of MRW at 10 mm Hg was 16.1 ± 5.0 µm and was not associated with any precannulation ONH feature (P = 0.24). However, healthy eyes with greater thickness return at 10 mm Hg had greater loss of MRW and retinal nerve fiber layer (RNFL) at a cumulative IOP of 1000 mm Hg · days after induction of experimental glaucoma. In addition, MRW and RNFL thinning was correlated with an increase in axial length (P < 0.01). Conclusion This study's findings suggest that the ONH's response to transient changes in IOP are associated with features of the ONH and surrounding tissues. The neural rim properties at baseline and the extent of axial elongation are associated with the severity of glaucomatous loss in the nonhuman primate model.
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Affiliation(s)
- Nimesh B Patel
- University of Houston College of Optometry, Houston, Texas, United States
| | | | - Laura J Frishman
- University of Houston College of Optometry, Houston, Texas, United States
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Kim S, Jo YH. Changes of Optical Coherence Tomography Parameters after Cataract Surgery in Primary Open-Angle Glaucoma Eyes. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:1-11. [PMID: 36281574 PMCID: PMC9935070 DOI: 10.3341/kjo.2022.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/22/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the impact of uncomplicated cataract surgery on the measurement of Bruch's membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG) patients. METHODS This retrospective study included 63 eyes of 63 patients, including 32 POAG eyes and 31 normal eyes who underwent uneventful cataract surgery and follow-up for at least 6 months. Using SD-OCT, BMO-MRW and RNFLT were measured preoperatively and postoperatively at 6 months. Paired t-test was used to compare intraocular pressure (IOP), BMO-MRW, RNFLT, and image quality before and after surgery. These parameters and their changes were compared between POAG and normal groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with the postoperative change (Δ) in RNFLT and BMO-MRW. RESULTS BMO-MRW and RNFLT were significantly increased and IOP was decreased after phacoemulsification in both groups (p < 0.001, respectively). The ΔRNFLT was significantly greater in POAG eyes compared with the normal eyes (p < 0.001). The ΔRNFLT was associated with the postoperative IOP reduction and glaucoma diagnosis (p < 0.001 and p = 0.001, respectively). In the normal group, only the ΔIOP had a significant influence on the ΔRNFLT (p = 0.003), but in the POAG group, not only the ΔIOP (p = 0.044) but also preoperative visual field mean deviation (p = 0.029) showed a significant influence. The ΔBMO-MRW showed no difference between POAG and normal eyes. CONCLUSIONS The postoperative increase of RNFLT was significantly greater in the POAG group, and the postoperative increase of RNFLT was associated with the preoperative visual field mean deviation and ΔIOP in POAG eyes and with the ΔIOP in normal eyes. Our results imply that RNFLT is more affected than BMO-MRW in POAG eyes compared to normal eyes by cataract surgery.
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Affiliation(s)
- SoHyeon Kim
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Youn Hye Jo
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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