Laminar and Prelaminar Tissue Displacement During Intraocular Pressure Elevation in Glaucoma Patients and Healthy Controls
Laminar and Prelaminar Tissue Displacement During Intraocular Pressure Elevation in Glaucoma Patients and Healthy Controls
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DOI：
10.1016/j.ophtha.2010.05.016
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发表时间：
2011-01-01
期刊：
影响因子：
13.7
通讯作者：
Chauhan, Balwantray C.
中科院分区：
文献类型：
--
作者：
Agoumi, Younes;Sharpe, Glen P.;Chauhan, Balwantray C.
目的：确定青光眼患者和健康受试者的前筛板和前板组织对眼内压（IOP）急性升高的反应。设计：前瞻性病例对照系列。参与者和对照：开角型青光眼患者（n = 12;平均年龄+/-标准差[SD]，66.8 ± 6.0岁），年龄匹配的健康对照（n = 12;平均年龄+/- SD，67.1 +/- 6.2岁）和年轻对照组（n = 12;平均年龄+/- SD，36.1 +/- 11.7岁）。一只眼睛进行成像与光谱域光学相干断层扫描，以获得12个高分辨率的径向扫描视盘为中心。通过下眼睑垂直于地球仪，在完全相同的位置重复成像，以升高IOP。在基线和升高的IOP图像中，使用4次径向扫描中连接布鲁赫膜开口的线作为参考。在2组图像中，在沿参考线的等距点沿着测量参考线到前板前组织表面和前板表面的垂直距离。两组相应测量值之间的差异用于确定椎板位移（LD）和椎板前组织位移（PTD.Main Outcome Measures：Laminar displacement and PTD.Results：患者、年龄匹配的对照组和年轻对照组的眼内压升高相似（平均值± SD，12.4 ± 3.2 mmHg）。平均+/- SD LD和PTD分别为0.5 +/- 3.3 μ m和15.7 +/- 15.5 μ m。LD与0比较无显著性差异（P = 0.366），PTD与0比较有显著性差异（P < 0.001）。各组之间的平均+/- SD LD相似（分别为-0.5 ± 3.7 μ m、0.2 ± 2.0 μ m和2.0 ± 3.6 μ m; P = 0.366），而平均+/- SD PTD不同（分别为6.8 +/- 13.7 μ m、20.8 +/- 17.5 μ m和19.6 +/- 11.8 μ m; P = 0.045）。在所有受试者中，PTD均大于LD。在多因素回归分析中，LD与视盘大小呈负相关（P = 0.007），而PTD与眼压升高的程度呈正相关（P = 0.013）。结论：在青光眼患者和对照组中，前板表面是不符合急性眼压升高。急性视盘表面变化代表椎板前组织受压，而非椎板移位。
Objective: To determine the response of the anterior lamina cribrosa and prelaminar tissue to acute elevation of intraocular pressure (IOP) in glaucoma patients and healthy subjects.Design: Prospective case-control series.Participants and Controls: Patients with open-angle glaucoma (n = 12; mean age +/- standard deviation [SD], 66.8 +/- 6.0 years), age-matched healthy controls (n = 12; mean age +/- SD, 67.1 +/- 6.2 years), and young controls (n = 12; mean age +/- SD, 36.1 +/- 11.7 years).Methods: One eye was imaged with spectral-domain optical coherence tomography to obtain 12 high-resolution radial scans centered on the optic disc. Imaging was repeated at precisely the same locations with an ophthalmodynamometer held perpendicular to the globe via the inferior lid to raise the IOP. A line joining Bruch's membrane opening in 4 radial scans was used as reference in the baseline and elevated IOP images. The vertical distance from the reference line to the anterior prelaminar tissue surface and anterior laminar surface was measured at equidistant points along the reference line in the 2 sets of images. The difference between the 2 sets of corresponding measurements were used to determine laminar displacement (LD) and prelaminar tissue displacement (PTD).Main Outcome Measures: Laminar displacement and PTD.Results: Intraocular pressure elevation among patients, age-matched controls, and young controls was similar (mean +/- SD, 12.4 +/- 3.2 mmHg). The mean +/- SD LD and PTD were 0.5 +/- 3.3 mu m and 15.7 +/- 15.5 mu m, respectively. The LD was not statistically different from 0 (P = 0.366), but PTD was (P < 0.001). The mean +/- SD LD was similar among the groups (-0.5 +/- 3.7 mu m, 0.2 +/- 2.0 mu m, and 2.0 +/- 3.6 mu m, respectively; P = 0.366), whereas the mean +/- SD PTD was different (6.8 +/- 13.7 mu m, 20.8 +/- 17.5 mu m, and 19.6 +/- 11.8 mu m, respectively; P = 0.045). In all subjects, the PTD was greater than LD. In multivariate regression analyses, LD was negatively associated with optic disc size (P = 0.007), whereas PTD was positively associated with the degree of IOP elevation (P = 0.013).Conclusions: In glaucoma patients and controls, the anterior laminar surface is noncompliant to acute IOP elevation. Acute optic disc surface changes represent compression of prelaminar tissue and not laminar displacement.