Tortuous Pore Path Through the Glaucomatous Lamina Cribrosa.

Area of Science:

• Ophthalmology
• Neuroscience
• Biomedical Engineering

Background:

• The lamina cribrosa is a critical site for retinal ganglion cell axons and a primary area affected in glaucoma.
• Mechanical forces are suspected to impede axoplasmic flow, but the precise pathways of axons through lamina cribrosa pores remain unclear.

Purpose of the Study:

• To investigate and quantify the in vivo tortuosity of lamina cribrosa pore paths in healthy and glaucomatous eyes.
• To explore the relationship between pore path characteristics and glaucoma severity.

Main Methods:

• Utilized swept-source optical coherence tomography to image lamina cribrosa pores in 70 subjects (16 healthy, 23 glaucoma suspect, 48 glaucomatous).
• Employed automated segmentation and custom software for tracking individual pore paths through the lamina cribrosa.
• Quantified pore path convergence to the optic nerve center and tortuosity.

Main Results:

• Lamina cribrosa pore pathways consistently trended closer to the optic nerve center with depth, irrespective of disease status.
• Eyes with glaucoma exhibited significantly more tortuous pore paths compared to healthy eyes.
• Pore path tortuosity did not correlate with disease severity or diagnostic category.

Conclusions:

• Increased tortuosity of lamina cribrosa pores in glaucoma may represent a key mechanism contributing to reduced axoplasmic flow.
• Understanding these pathways offers insights into glaucoma pathogenesis and potential therapeutic targets.