title: Enhanced depth imaging optical coherence tomography of deep optic nerve complex structures in glaucoma.
abstract: OBJECTIVE
  To assess the usefulness of enhanced depth imaging (EDI) optical coherence tomography (OCT) for evaluating deep structures of the optic nerve complex (ONC; optic nerve head and peripapillary structures) in glaucoma.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Seventy-three established glaucoma patients (139 eyes) with a range of glaucomatous damage.
  
  
  METHODS
  Serial horizontal and vertical EDI OCT images of the ONC were obtained from both eyes of each participant. Deep ONC structures, including the lamina cribrosa (LC), short posterior ciliary artery (SPCA), central retinal artery (CRA), central retinal vein (CRV), peripapillary choroid and sclera, and subarachnoid space around the optic nerve, were investigated for their visibility and morphologic features.
  
  
  METHODS
  Deep ONC structures identified in EDI OCT images.
  
  
  RESULTS
  Visual field mean deviation of 139 included eyes was -11.8 ± 8.6 dB (range, -28.70 to -2.01 dB). The anterior laminar surface was identified in all eyes in the central laminar area and in 91 (65%) eyes in the periphery beneath the neuroretinal and scleral rims or vascular structures. The LC pores with various shapes and sizes were visualized in 106 (76%) eyes, mainly in the central and temporal areas of the LC. Localized LC lesions seen on optic disc photographs were identified as focal LC defects (partial loss of LC tissue) in the EDI OCT images. The locations of the CRA and CRV were identified in all eyes. In the LC, the CRA maintained a straight shape with a consistent caliber, but the CRV (and tributaries) assumed a more irregular shape. The SPCAs, their branches through the emissary canals in the sclera, or both were visualized in 120 (86%) eyes. The subarachnoid space around the optic nerve was identified with varying degrees of clarity in 25 eyes (18%): 17 had high myopia and extensive parapapillary atrophy. Intrachoroidal cavitation or choroidal schisis, which had been unrecognized clinically, was identified in 2 eyes (1%) with high myopia.
  
  
  CONCLUSIONS
  Enhanced depth imaging OCT was able to visualize a wide variety of deep ONC structures in glaucoma patients and may be helpful in detecting, conceptualizing, and understanding basic and complicated in vivo anatomic and pathologic features of the ONC in glaucoma.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York 10003, USA. sungchulpark1225@gmail.com
authors: Sung Chul
authors: SC
authors: Park
authors: Carlos Gustavo V
authors: CG
authors: De Moraes
authors: Christopher C
authors: CC
authors: Teng
authors: Celso
authors: C
authors: Tello
authors: Jeffrey M
authors: JM
authors: Liebmann
authors: Robert
authors: R
authors: Ritch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology; D019842:Ciliary Arteries / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010865:Pilot Projects; D011446:Prospective Studies; D012161:Retinal Artery / Q000473:pathology*; D012169:Retinal Vein / Q000473:pathology*; D012590:Sclera / Q000473:pathology; D013346:Subarachnoid Space / Q000473:pathology; D041623:Tomography, Optical Coherence; D055815:Young Adult