Reversal of lamina cribrosa displacement after intraocular pressure reduction in open-angle glaucoma

Ophthalmology. 2013 Mar;120(3):553-559. doi: 10.1016/j.ophtha.2012.08.047. Epub 2012 Dec 6.


Purpose: To compare the change in lamina cribrosa (LC) displacement in response to intraocular pressure (IOP) lowering in patients with open-angle glaucoma (OAG) using spectral-domain optical coherence tomography (SD-OCT).

Design: Observational case series.

Participants: One hundred eyes of 100 patients with OAG in whom IOP at the follow-up examination had decreased by at least 20% compared with the baseline IOP.

Methods: Serial horizontal B-scan images of the optic nerve head (ONH) were obtained from each eye using enhanced depth imaging SD-OCT. Approximately 65 B-scans covering the optic discs were obtained before and 3 to 6 months after lowering IOP. The baseline and follow-up LC depths (the distance from the Bruch's membrane opening plane to the level of the anterior LC surface) were measured in B-scan images from each eye.

Main outcome measures: The mean and maximum amount of reductions in LC depth measured in the 7 selected B-scan images.

Results: Intraocular pressure decreased from 21.2±9.1 to 10.5±2.6 mmHg. The percent of IOP reduction was significantly related to the untreated IOP (P < 0.001). There was a significant decrease in the LC depth at the follow-up examination compared with the baseline value (P < 0.001). The magnitude of LC depth reduction was significantly associated with younger age, higher untreated IOP, higher baseline IOP, and greater percent of IOP reduction (all P < 0.02).

Conclusions: Reversal of the LC displacement was observed after IOP-lowering treatment in OAG. The degree of LC displacement reversal was related to the amount of IOP lowering.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Glaucoma, Open-Angle / physiopathology*
  • Glaucoma, Open-Angle / surgery
  • Gonioscopy
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Optic Disk / physiopathology*
  • Optic Nerve Diseases / physiopathology*
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Trabeculectomy
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields
  • Young Adult