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Thick Prelaminar Tissue Decreases Lamina Cribrosa Visibility

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; Fujimoto, James G; Grulkowski, Ireneusz; ... Show more Show less
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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.
Date issued
2017-03
URI
http://hdl.handle.net/1721.1/109904
Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
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
ISSN
1552-5783

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