RESUMEN
PRCIS: Glaucoma was associated with axial bowing and rotation of Bruchs membrane opening (BMO) and anterior laminar insertion (ALI), skewed neural canal, and deeper anterior lamina cribrosa surface (ALCS). Longer axial length was associated with wider, longer, and more skewed neural canal and flatter ALCS. PURPOSE: Investigate the effects of myopia and glaucoma in the prelaminar neural canal and anterior lamina cribrosa using 1060-nm swept-source optical coherence tomography. PATIENTS: 19 control (38 eyes) and 38 glaucomatous subjects (63 eyes). MATERIALS AND METHODS: Participants were imaged with swept-source optical coherence tomography, and the images were analyzed for the BMO and ALI dimensions, prelaminar neural canal dimensions, and ALCS depth. RESULTS: Glaucomatous eyes had more bowed and nasally rotated BMO and ALI, more horizontally skewed prelaminar neural canal, and deeper ALCS than the control eyes. Increased axial length was associated with a wider, longer, and more horizontally skewed neural canal and a decrease in the ALCS depth and curvature. CONCLUSION: Our findings suggest that glaucomatous posterior bowing or cupping of lamina cribrosa can be significantly confounded by the myopic expansion of the neural canal. This may be related to higher glaucoma risk associated with myopia from decreased compliance and increased susceptibility to IOP-related damage of LC being pulled taut.
Asunto(s)
Glaucoma , Miopía , Disco Óptico , Humanos , Tomografía de Coherencia Óptica/métodos , Tubo Neural , Presión Intraocular , Glaucoma/complicaciones , Glaucoma/diagnóstico , Miopía/complicaciones , Miopía/diagnósticoAsunto(s)
Neurosífilis/complicaciones , Disco Óptico/patología , Enfermedades del Nervio Óptico/etiología , Antibacterianos/uso terapéutico , Coriorretinitis/complicaciones , Coriorretinitis/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Glaucoma/diagnóstico , Humanos , Presión Intraocular/fisiología , Persona de Mediana Edad , Neurosífilis/diagnóstico , Enfermedades del Nervio Óptico/diagnóstico , Penicilina G/uso terapéutico , Agudeza Visual/fisiología , Pruebas del Campo Visual , Campos Visuales/fisiologíaRESUMEN
Although intraocular pressure remains the main modifiable risk factor for open-angle glaucoma, other factors such as vascular perfusion likely play a significant role. It is not clear how mechanical deformation, axonal damage, glial responses, and ischemia interact to lead to the tissue remodeling seen clinically as glaucomatous cupping. To understand the potential role of vascular risk factors in glaucoma, it is important to understand the vascular anatomy of the optic nerve head (ONH). The focus of this review is to provide a description of the vascular anatomy of the ONH and to describe recent work in the central nervous system that suggests that astrocytes play a key role in vascular regulation. Finally, the evidence for vascular regulation in the ONH and retina is reviewed.