Thick Prelaminar Tissue Decreases Lamina Cribrosa Visibility
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Lucy-2017-Thick Prelaminar Tissue Decreases La.pdf
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Author(s)
Lucy, Katie A.
Wang, Bo
Schuman, Joel S.
Bilonick, Richard A.
Ling, Yun
Kagemann, Larry
Sigal, Ian A.
Ishikawa, Hiroshi
Wollstein, Gadi
Liu, Jonathan Jaoshin
Date Issued
March 2017
Journal
Investigative Opthalmology & Visual Science
Publisher
Association for Research in Vision and Ophthalmology
Citation
Lucy, Katie A.; Wang, Bo; Schuman, Joel S.; Bilonick, Richard A.; Ling, Yun; Kagemann, Larry; Sigal, Ian A. et al. “Thick Prelaminar Tissue Decreases Lamina Cribrosa Visibility.” Investigative Opthalmology & Visual Science 58, no. 3 (March 2017): 1751 © 2017 The Authors
Version
Final published version
Abstract
Purpose: Evaluation of the effect of prelaminar tissue thickness on visualization of the lamina cribrosa (LC) using optical coherence tomography (OCT).
Methods: The optic nerve head (ONH) region was scanned using OCT. The quality of visible LC microstructure was assessed subjectively using a grading system and objectively by analyzing the signal intensity of each scan's superpixel components. Manual delineations were made separately and in 3-dimensions quantifying prelaminar tissue thickness, analyzable regions of LC microstructure, and regions with a visible anterior LC (ALC) boundary. A linear mixed effect model quantified the association between tissue thickness and LC visualization.
Results: A total of 17 healthy, 27 glaucoma suspect, and 47 glaucomatous eyes were included. Scans with thicker average prelaminar tissue measurements received worse grading scores (P = 0.007), and superpixels with low signal intensity were associated significantly with regions beneath thick prelaminar tissue (P < 0.05). The average prelaminar tissue thickness in regions of scans where the LC was analyzable (214 μm) was significantly thinner than in regions where the LC was not analyzable (569 μm; P < 0.001). Healthy eyes had significantly thicker average prelaminar tissue measurements than glaucoma or glaucoma suspect eyes (both P < 0.001), and glaucoma suspect eyes had significantly thicker average prelaminar tissue measurements than glaucoma eyes (P = 0.008). Significantly more of the ALC boundary was visible in glaucoma eyes (63% of ONH) than in healthy eyes (41%; P = 0.005).
Conclusions: Thick prelaminar tissue was associated with impaired visualization of the LC. Healthy subjects generally had thicker prelaminar tissue, which potentially could create a selection bias against healthy eyes when comparing LC structures.
MIT Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
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DOI of Published Version
https://doi.org/10.1167/iovs.16-20784
