Regional Deformation of the Optic Nerve Head and Peripapillary Sclera During IOP Elevation

To measure the deformation of the porcine optic nerve head (ONH) and peripapillary sclera (PPS) in response to intraocular pressure (IOP) elevation.

High-frequency ultrasound was used to image the ONH and PPS of 12 porcine eyes during ex vivo inflation testing from 5 to 30 mm Hg. A speckle tracking algorithm was used to compute tissue displacements in the anterior-posterior direction and expansion of the scleral canal. Through-thickness, in-plane, and shear strains were calculated within the ONH. Regional displacements and strains were analyzed and compared.

The ONH and PPS showed overall posterior displacement in response to IOP elevation. Posterior displacement of the ONH was larger than and strongly correlated with the posterior displacement of the PPS throughout inflation testing. Scleral canal expansion was much smaller and leveled off quicker than ONH posterior displacement as IOP increased. Through-thickness compression was concentrated in the anterior ONH, which also experienced larger in-plane and shear strains than the posterior ONH. Within the anterior ONH, all three strains were significantly higher in the periphery compared with the center, with the shear strain exhibiting the greatest difference between the two regions.

High-resolution ultrasound speckle tracking revealed the full-thickness mechanical response of the posterior eye to IOP elevation. A mismatch in posterior displacement was found between the ONH and PPS, and regional analyses showed a concentration of strains within the periphery of the anterior porcine ONH. These deformation patterns may help in understanding IOP-associated optic nerve damage and glaucoma susceptibility.