Lamina cribrosa curvature index and its relationship with morphofunctional and microcirculatory disorders in glaucoma

PURPOSE. To study the relationship of the lamina cribrosa curvature index with morphofunctional and microvascular parameters in glaucoma.

METHODS. The lamina cribrosa curvature index (LCCI) was studied using optical coherence tomography (OCT) in 108 patients (108 eyes) with primary open-angle glaucoma and 45 controls (45 eyes) aged 60 to 81 years. Additionally, all subjects underwent OCT measurement of the thickness of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), OCT angiography to determine vessel density in the optic nerve disc, macula (fovea and parafovea), as well as measurement of the area of peripapillary choroidal atrophy (PCA), choroidal microvasculature dropout (cMvD) and the peripapillary choroidal thickness (CTp).

RESULTS. LCCI was significantly higher in patients with glaucoma compared to the controls: 7.65±0.17 and 8.68±0.39, respectively (p=0.016). Significant correlations of LCCI with perimeter indices were revealed in glaucoma, but not in the control group: MD (r=-0.563; p<0.01) and PSD (r=0.454; p<0.01), as well as with RNFL parameters (r=-0.509; p<0.01) and GCC (r=-0.618; p<0.01), parafoveal retinal thickness (r=-0.530; p<0.01) and peripapillary choroid (r=-0.518; p<0.01). An inverse relationship was observed between LCCI and capillary density in the ONH (r=-0.480; p<0.01) and in fovea and parafovea (r=-0.455; p<0.01). Larger area of choroidal microvasculature dropout (cMvD) corresponded to higher LCCI values (r=0.506; p<0.01).

CONCLUSION. LCCI is an important biomarker of glaucoma lesions. The relationship of this indicator with the parameters of the microcirculatory bed in the retina, ONH and choroid, as well as with morphofunctional parameters indicates early involvement of the lamina cribrosa in the glaucoma process.

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