title: Posterior displacement of the lamina cribrosa in glaucoma: in vivo interindividual and intereye comparisons.
abstract: OBJECTIVE
  We assessed in vivo lamina cribrosa (LC) position within the optic nerve head in glaucoma.
  
  
  METHODS
  For interindividual comparison, glaucoma patients at various stages and normal subjects were recruited. For intraindividual, intereye comparison, glaucoma patients with visual field (VF) defects in only one eye were recruited separately. Serial horizontal and vertical enhanced depth imaging optical coherence tomography (EDI OCT) B-scans of the optic nerve head were obtained prospectively from each participant. Mean and maximum anterior LC depths were measured in 11 equally spaced horizontal B-scans, excluding the LC insertion area under the Bruch's membrane and scleral rim.
  
  
  RESULTS
  Totals of 47 glaucomatous eyes (47 patients; VF mean deviation, -12.7±8.2 dB) and 57 normal eyes (57 subjects) were enrolled for the interindividual comparison. Mean and maximum LC depths were significantly greater in the glaucomatous than in the normal eyes in all 11 scans (all P<0.03). There were 54 glaucoma patients with VF defects in only one eye (VF mean deviation, -15.6±8.8 dB) included in the intereye comparison. Mean and maximum LC depths were significantly greater in the eyes with VF defects than in the fellow eyes with no VF defects in all 11 scans (all P<0.01).
  
  
  CONCLUSIONS
  The central and midperipheral LC is located more posteriorly in glaucomatous than in normal eyes, as well as in eyes with VF defects compared to fellow eyes with no VF defects. These results support the concept of posterior LC displacement in glaucoma and provide the basis for future in vivo human studies.
authors.affiliation: Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York 10003, USA.
authors.forename: Rafael L
authors.initials: RL
authors.lastname: Furlanetto
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Park
authors.forename: Uma J
authors.initials: UJ
authors.lastname: Damle
authors.forename: Sandra Fernando
authors.initials: SF
authors.lastname: Sieminski
authors.forename: Yungtai
authors.initials: Y
authors.lastname: Kung
authors.forename: Nora
authors.initials: N
authors.lastname: Siegal
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003238:Connective Tissue / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009900:Optic Nerve / Q000473:pathology*; D057972:Posterior Eye Segment; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: glaucoma posterior segment; lamina cribrosa; optical coherence tomography