Dynamic of the Three-dimensional Microarchitecture of Lamina Cribrosa Pores using Optical Coherence Tomography

We found a significant increase in lamina cribrosa (LC) pore length after surgical IOP reduction in patients with glaucoma. This change in the LC microarchitecture was correlated with changes in macroarchitectural parameters.

To investigate the dynamic changes in LC three-dimensional microarchitecture following surgical IOP reduction.

Ten eyes of 10 glaucoma patients were imaged with spectral domain optical coherence tomography (SD-OCT) before and one month after glaucoma surgery. The pre- and postoperative LC depth and the thickness of LC and prelaminar tissue were determined on a median vertical section of the optic nerve head. Laminar pores were traced using a semi-automatic segmentation software. Pore length, tortuosity and verticality were measured on the 3D reconstructions.

The intraocular pressure (IOP) decreased from 23.6±9.03 (mean±SD) to 11.3±3.68 mmHg at one month post-surgery (P<0.001). The mean LC depth was reduced from 571.8±125.6 to 419.9±96.0 μm (P=0.006). LC thickness increased significantly (228.8±29.27 preoperatively to 284.4±83.61 μm postoperatively (P=0.016)). No significant increase in the prelaminar tissue thickness was noted (132.7±42.46 preoperatively and 173.1±63.79 μm postoperatively (P=0.101)). In lamina 3D microarchitecture, pore length was significantly greater postoperatively (P=0.01). No significant difference was observed in tortuosity or verticality (P=0.912 and P=0.159 respectively).

We found a significant increase in LC pore length after glaucoma surgery using SD-OCT of the optic nerve head. Further studies are necessary to better characterize the dynamics of laminar microarchitecture and its influence on the prognosis of glaucomatous neuropathy.