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Kambayashi M, Saito H, Araie M, Enomoto N, Murata H, Kikawa T, Sugiyama K, Higashide T, Miki A, Iwase A, Tomita G, Nakazawa T, Aihara M, Ohno-Matsui K, Kim TW, Leung CKS, Zangwill LM, Weinreb RN. Effects of Deep Optic Nerve Head Structures on Bruch's Membrane Opening- Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer. Am J Ophthalmol 2024; 263:99-108. [PMID: 38403100 DOI: 10.1016/j.ajo.2024.02.017] [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: 11/23/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE To explore the effects of deep optic nerve head (ONH) structures on Bruch's membrane opening (BMO)-minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) in healthy eyes. DESIGN Prospective cross-sectional study. METHODS Two hundred five healthy eyes of 141 subjects (mean ± standard deviation of age and axial length (AXL): 46.9 ± 10.0 years and 24.79 ± 1.15 mm) were enrolled. Best fit multivariable linear mixed models identified factors associated with BMO-MRW and pRNFLT. Explanatory variables included age, gender, AXL, BMO and anterior scleral canal opening (ASCO) area and ovality, magnitude of BMO and ASCO shift, peripapillary choroidal thickness, lamina cribrosa (LC) parameters, prelaminar thickness, and peripapillary scleral (PPS) angle. RESULTS Thinner BMO-MRW was associated with older age, smaller ASCO/BMO offset magnitude, larger BMO area, thinner prelaminar thickness, deeper LC, and thinner pRNFLT (P = .011, <.001, .004, <.001, <.001, <.001 respectively). Thinner pRNFLT was associated with shorter AXL, smaller ASCO area, a more posteriorly bowed PPS, shallower LC and thinner BMO-MRW. (P = .030, .002, .035, .012, <.001 respectively) CONCLUSIONS: BMO-MRW and pRNFLT were influenced by several deep ONH structures such as BMO and ASCO position shift, BMO or ASCO area, prelaminar thickness, PPS bowing and LC depth in addition to patient characteristics such as age and AXL. The degree and/or direction of associations varied between deep ONH structures and BMO-MRW or pRNFLT. Despite both BMO-MRW and pRNFLT being surrogate parameters for RGC loss, a complex relationship with ONH deep-layer morphology was indicated.
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Affiliation(s)
- Mitsuki Kambayashi
- From the Department of Ophthalmology (M.K., H.S., M.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hitomi Saito
- From the Department of Ophthalmology (M.K., H.S., M.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers (M.A.), Tokyo, Japan
| | | | - Hiroshi Murata
- Center Hospital of the National Center for Global Health and Medicine (H.M.), Tokyo, Japan
| | | | - Kazuhisa Sugiyama
- Department of Ophthalmology (K.S., T.H.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Tomomi Higashide
- Department of Ophthalmology (K.S., T.H.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Atsuya Miki
- Department of Innovative Visual Science (A.M.), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Myopia Control Research (A.M.), Aichi Medical University Medical School, Nagakute, Japan
| | - Aiko Iwase
- Tajimi Iwase Eye Clinic (A.I.), Tajimi, Japan
| | - Goji Tomita
- Department of Ophthalmology (G.T.), Toho University Ohashi Medical Center, Tokyo, Japan
| | - Toru Nakazawa
- Department of Ophthalmology (T.N.), Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Makoto Aihara
- From the Department of Ophthalmology (M.K., H.S., M.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science (K.O.-M.), Tokyo Medical and Dental University, Tokyo, Japan
| | - Tae-Woo Kim
- Department of Ophthalmology (T.-W.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Christopher Kai Shun Leung
- Department of Ophthalmology, LKS Faculty of Medicine (C.S.K.L.), the University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology (L.M.Z., R.N.W.), University of California San Diego, La Jolla, CA, United States
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology (L.M.Z., R.N.W.), University of California San Diego, La Jolla, CA, United States
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Hepokur M, Elgin CY, Gunes M, Sali F, Oguz H. A comprehensive enhanced depth imaging spectral-domain optical coherence tomography analysis of pseudoexfoliation spectrum from non-glaucomatous to advanced stage glaucoma in the aspect of Bruch's membrane opening-minimum rim width. Int Ophthalmol 2022; 42:1835-1847. [PMID: 34984628 DOI: 10.1007/s10792-021-02181-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the correlations between lamina cribrosa (LC) and related structures with Bruch's membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness in pseudoexfoliation syndrome (PXS) and different stages of pseudoexfoliation glaucoma (PXG). METHODS This prospective cross-sectional study included 32 PXS eyes of 24 patients and 94 PXG eyes (early-stage (n: 55) and advanced-stage glaucoma (n: 39) of 78 patients. Global and six sectors of RNFL thicknesses and BMO-MRW parameters were measured with enhanced depth imaging (EDI) mode of SD-OCT. Structural parameters; lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), prelaminar tissue thickness (PLTT), four quadrants of peripapillary choroidal thicknesses (PPCT), and subfoveal choroidal thickness (SFCT) were measured and statistical relationships between the structural parameters have been laid out. We apply the generalized estimating equations method to take into account dependency of right and left eyes. RESULTS From PXS to mild and advanced PXG groups LCT and PLTT decrease from 147.29 ± 33.10, 145.62 ± 30.64, 126.30 ± 29.14 and 260.93 ± 185.07, 247.27 ± 142.58, 159.89 ± 86.84, respectively, and LCD varies as 159.89 ± 86.84, 420.88 ± 117.80, and 505.64 ± 183.25. The correlations between LCD, LCT, and PLTT and the stage of the disease are significant. BMO-MRW shows slightly stronger correlations than the RNFL with LC related parameters. SFCT does not exhibit any significant relationship with the stage of the disease. However, PPCT in only the interior quadrant does. The significant correlations between LCD and all quadrants of PPCT is the sign of important anatomic relationship. CONCLUSION These findings show that the BMO-MRW parameter may be more sensitive than RNFL and can safely be used in the diagnosis and follow-up in PXS and PXG, but this result should be supported with longer and larger series.
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Affiliation(s)
- Mustafa Hepokur
- Department of Ophthalmology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Cansu Yuksel Elgin
- Department of Ophthalmology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey.
| | - Medine Gunes
- Department of Ophthalmology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey.,Department of Ophthalmology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey
| | - Fatma Sali
- Department of Ophthalmology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey.,Department of Ophthalmology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey
| | - Halit Oguz
- Department of Ophthalmology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey.,Department of Ophthalmology, Istanbul Medeniyet University Medical Faculty, Istanbul, Turkey
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Naderi Beni A, Entezari D, Koosha N, Kianersi F, Naderan M. Ganglion cell complex and macular thickness layers in primary open-angle glaucoma, pseudoexfoliation glaucoma and healthy eyes: A comparative study. Photodiagnosis Photodyn Ther 2021; 36:102563. [PMID: 34614425 DOI: 10.1016/j.pdpdt.2021.102563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the differences in the ganglion cell complex (GCC) and macular thickness measurements between primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and healthy eyes with optical coherence tomography (OCT)optovue. METHODS In this non-randomized comparative cross-sectional study, 43 healthy eyes, 68 POAG eyes, and 57 PXG eyes were included. Patients were matched for age and disease severity. OCT angiography images were obtained for automated measurement of the GCC and macular thickness layers (inner and outer). RESULTS All GCC parameters were significantly difference between healthy and glaucomatous eyes (mild, and moderate to severe disease).There were no significant differences in GCC parameters between POAG and PXG patients except focal loss volume (FLV) after adjustment. Moderate to severe PXG eyes exhibited significantly lower GCC, larger global loss volume (GLV) values, and FLV values when compared with mild PXG eyes (p<= 0.05). We found significant thinning patterns in inner retinal thickness (fovea, parafovea, and perifovea), and total retinal thickness (parafovea, and perifovea) in moderate to severe PXG eyes when comparing with POAG eyes. Patients with moderate to severe PXG also showed significantly thinning patterns in inner retinal layers (fovea, parafovea and perifovea) and total retinal thickness (nasal parafovea) in compared to mild PXG. CONCLUSION It appears that GCC thickness is not significantly different between POAG and PXG except FLV. Despite similar retinal thickness in mild disease, a significant reduction in total and inner retinal thickness was demonstrated in moderate to severe PXG compared to moderate to severe POAG, in fovea, parafovea and perifovea region.
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Affiliation(s)
- Afsaneh Naderi Beni
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Davoud Entezari
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nima Koosha
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzan Kianersi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Naderan
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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