title: Anterior lamina cribrosa insertion in primary open-angle glaucoma patients and healthy subjects.
abstract: OBJECTIVE
  To determine using swept-source optical coherence tomography (SS-OCT) whether there are differences in the location of the anterior lamina cribrosa insertion (ALI) in primary open-angle glaucoma (POAG) patients and healthy subjects.
  
  
  METHODS
  Fifty three eyes from 53 patients with POAG, and 53 eyes from 53 age-matched healthy subjects were included prospectively in Seoul National University Bundang Hospital. Twelve radial line B-scans centered on the optic disc in every half-clock-hour meridian were acquired using SS-OCT. The ALI position was assessed by measuring two parameters: (1) ALI distance (ALID)--the distance from the anterior scleral canal opening (ASCO) to the ALI; and (2) marginal anterior lamina cribrosa surface depth (mALCSD)--the perpendicular distance from the ASCO plane to the anterior lamina cribrosa surface. These parameters were compared between the two groups for each meridian.
  
  
  RESULTS
  Both ALID (256 ± 54 vs. 209 ± 37 µm, mean ± SD, p < 0.001) and mALCSD (232 ± 63 vs. 187 ± 40 µm, p < 0.001) were significantly greater in the POAG group than in the normal group. The largest difference was observed at the 6.5 o'clock and 11.5 o'clock meridians for both ALID and mALCSD. Multiple regression analysis revealed a negative correlation between age and both ALID and mALCSD in the control group, and a negative correlation between mean deviation of the visual field test and both ALID and mALCSD in the POAG group.
  
  
  CONCLUSIONS
  The ALI was displaced posteriorly in eyes with POAG compared to those of healthy controls. This finding suggests that the posteriorly located lamina cribrosa insertion is an important component of glaucomatous optic nerve excavation.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Tae-Woo
authors.initials: TW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology and Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Bioengineering, National University of Singapore, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Michaël J A
authors.initials: MJ
authors.lastname: Girard
authors.affiliation: INSERM U1032, Université de Lyon, Lyon, France.
authors.forename: Jean Martial
authors.initials: JM
authors.lastname: Mari
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000473:pathology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D012044:Regression Analysis; D041623:Tomography, Optical Coherence; D014792:Visual Acuity