Biometric and morphometric parameters of the lamina cribrosa in patients with different stages of primary open-angle glaucoma

PURPOSE. To compare the thickness of the prelaminar nerve fiber layer and the depth of the lamina cribrosa in patients with different stages of primary open-angle glaucoma (POAG).

METHODS. We examined 39 patients (71 eyes) with different stages of primary open-angle glaucoma and 26 patients (52 eyes) without ophthalmic pathologies. The age of patients in the main and control groups was 63–82 years. Specific hypotensive instillations regimen was selected for the patients of the main group. In addition to assessing the general ophthalmic status of the study patients, their biomechanical parameters were determined using the Ocular Response Analyzer device (ORA; "Reichert Technologies", USA). Additionally, all patients underwent optical coherence tomography of the optic nerve head involving calculation of the lamina cribrosa depth (LCD) and the thickness of the prelaminar nerve fiber layer (tPNFL). Spearman's test was used as statistical evaluation criteria.

RESULTS. In patients with stages I and II POAG, lamina cribrosa depth amounted to 386±77 (p<0.45) and 380±50 μm (p<0.14), respectively. There was no statistically significant difference in LCD in comparison with the control group (389±96 µm), neither in patients with stages I nor II of the disease. At the same time, patients with stage III POAG were found to have statistically significantly the highest LCD relative to the norm (595±162 μm) (p<0.002). In healthy controls, tPNFL values were 334±187 µm, while tPNFLmin was 238±203 µm. Even in stage I POAG, tPNFLmin (158±106 μm) and tPNFL (205±94 μm) were statistically significantly lower than tPNFL and tPNFLmin in the control group (334±187 and 238±203 μm, respectively).

CONCLUSION. Optical coherence tomography allows assessing biometric parameters of all structures of the optic nerve head, including the lamina cribrosa. When analyzing patients with POAG by stages, it is important to note that the lamina cribrosa depth does not significantly differ relative to the control group. At the same time, the prelaminar nerve fiber layer thickness is significantly reduced at the initial stage of POAG and can serve as a factor in differential diagnosis of glaucoma. Thus, studying the parameters of the lamina cribrosa using spectral OCT at various stages of POAG opens up new possibilities in the diagnostics of the glaucomatous process at its initial stages.

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