Lamina cribrosa morphology and clinical implications in glaucoma with thin central corneal thickness

This study investigated the relationship between thin central corneal thickness (CCT) and lamina cribrosa (LC) morphology in patients with normal-tension glaucoma. Thin CCT was defined as a corneal thickness of less than 500 μm in both eyes, and all included patients had a corrected intraocular pressure of less than 20 mmHg. To investigate the LC-morphological characteristics observed in the Thin-CCT group (N = 60), the Normal-CCT group (N = 36) was set as the control. A subgroup analysis was performed on Progressors and Non-progressors using the visual field's progression rate to identify progression-related risk factors. The LC posterior displacement index was higher in the Thin-CCT group and the temporal anterior laminar insertion depth (ALID) was deeper in Progressors. In multivariate analyses, the risk of glaucoma progression increased with older age, thinner CCT, worse visual filed, deeper temporal ALID, and deeper mean LC depth. Notably, ALID showed a significant correlation with CCT. These findings suggest that in patients with normal-tension glaucoma, thinner CCT is associated with a more pronounced posterior displacement and deeper insertion of the LC, even under similar intraocular pressure conditions. The altered LC morphology observed in thin CCT may help explain the higher rate of glaucoma progression in this patient population.