Lamina cribrosa in glaucoma.
Lamina cribrosa in glaucoma.
复制标题
DOI：
10.1097/icu.0000000000000354
复制
发表时间：
2017-03
影响因子：
3.7
通讯作者：
Girkin CA
中科院分区：
文献类型：
--
作者：
Downs JC;Girkin CA
在以往研究的基础上，介绍、总结和解释青光眼筛板（LC）研究的最新进展。椎板是一种活跃的活性结构，其在青光眼的微观和宏观尺度上响应应变并改变形态。青光眼中LC形态的变化包括椎板插入巩膜的后移、LC杯状或深度增加以及局灶性LC缺损的发展。这些LC变化与椎间盘突出和视野损伤相关，并且可以用临床成像技术如光学相干断层扫描（OCT）检测到。LC中的青光眼性变化由局灶性周期性机械应变介导的细胞过程驱动。应变是眼睛特异性的，并由IOP、脑脊液压（CSFP）以及巩膜和LC形态和结构刚度介导;在所有平均IOP水平下都可能发生有害的LC应变。椎板形态在健康和疾病中不断变化，最近的研究已经确定了几个有希望的形态变化，这些变化指示青光眼易感性、发作和进展。
To present, summarize and interpret most recent advances in the study and understanding of the lamina cribrosa (LC) in glaucoma, in the context of previous work. The lamina is an active living structure that responds to strain and changes morphology at the micro- and macro-scales in glaucoma. Changes in LC morphology in glaucoma include posteriorization of the laminar insertion into the sclera, increased cupping or depth of the LC, and the development of focal LC defects. These LC changes are associated with disk hemorrhages and visual field damage, and are detectable with clinical imaging techniques such as optical coherence tomography (OCT). Glaucomatous changes in the LC are driven by cellular processes mediated by focal cyclical mechanical strain. Strain is eye specific and mediated by IOP, cerebrospinal fluid pressure (CSFP), and scleral and LC morphology and structural stiffness; deleterious LC strains can occur at all levels of mean IOP. Laminar morphology is ever changing in health and disease, and recent studies have identified several promising morphological changes that are indicative of glaucoma susceptibility, onset and progression.