Comparison and significance of scleral cribriform curvature in different types of glaucoma_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Zhengyi , Su Tingting , Chen Baowei ,  Hua Feng

Department of Ophthalmology, Cangnan County people's Hospital (Cangnan Hospital Affiliated to Wenzhou Medical University), Wenzhou 325800, China;

Corresponding?author：

Hua Feng, Email: huaf766@126.com

Keywords：

Glaucoma, open-angle; Glaucoma, angle-closure; Lamina curvature

DOI：

10.3760/cma.j.cn511434-20210218-00081

Video：

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Objective To observe the differences in scleral lamina curvature (SLC) of patients with pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma (POAG), and primary chronic angle-closure glaucoma (CPACG) were compared and analyzed and their significance was analyzed.Methods A retrospective clinical study. From June 2017 to December 2020, 30 PXG (PXG group), POAG (POAG group) and CPACG patients (CPACG group) diagnosed at Eye Center of Cangnan County people's Hospital of Zhejiang Province (Cangnan Hospital Affiliated to Wenzhou Medical University) were included in the study. The age difference between the three groups of patients was statistically significant (t=17.925, P=0.001); gender composition ratio (χ²=2.158, P=0.276), intraocular pressure (t=4.993, P=0.078), and axial length (t=1.956, P=0.532), central corneal thickness (t=1.407, P=0.724), average visual field defect (t=2.725, P=0.496), optic disc retinal nerve fiber layer thickness (t=2.185, P=0.492) in comparison, the differences were not statistically significant (P＞0.05). The frequency-domain optical coherence tomography deep-enhanced imaging (OCT EDI) technology was used to measure the average and 0°, 30°, 60°, 90°, 120°, 150° SLC of the affected eyes, and calculate the SLC index (SLCI) and SL curve depth (SLCD). Quantitative data comparison between groups used independent sample t test. Count data comparison used χ² test. Univariate and multivariate logistic regression analysis were used for correlation analysis.Results The results of OCT EDI examination showed that the SLC of eyes with PXG and CPACG was significantly steep, while the SLC of eyes with POAG was relatively flat. Except for the angle of 150°, the other 6 angles of SLCI and SLCD in the PXG group and CPACG group were higher than those in the POAG group, and the differences were statistically significant (P＜0.05). However, there was no statistically significant difference between PXG group and CPACG group for 7 angles of SLCI and SLCD (P＞0.05). Logistic regression analysis showed that the average SLCI [odds ratio (OR)=1.498, 95% confidence interval (CI) 1.137-2.018, P=0.001], age (OR=1.074, 95%CI 1.019-1.143, P=0.016) was significantly correlated with PXG; mean SLCI (OR=1.625, 95%CI 1.192-1.997, P=0.001), intraocular pressure (OR=1.383, 95%CI 1.106-1.993, P=0.012) was significantly correlated with CPACG. POAG group (β=0.143, 95%CI 0.032-0.208, P=0.016), CPACG group (β=0.132, 95%CI 0.079-0.315, P=0.043) intraocular pressure was correlated with mean SLCI; all factors of PXG group were correlated with SLCI without correlation (P＞0.05).Conclusion Compared with POAG, the SLC of eyes with PXG and CPACG is steeper and related to disease occurrence.

Citation： Li Zhengyi, Su Tingting, Chen Baowei, Hua Feng. Comparison and significance of scleral cribriform curvature in different types of glaucoma. Chinese Journal of Ocular Fundus Diseases, 2021, 37(6): 437-443. doi: 10.3760/cma.j.cn511434-20210218-00081 Copy

1.	Lopez NN, Clark AF, Tovar-Vidales T. Isolation and characterization of human optic nerve head astrocytes and lamina cribrosa cells[J/OL]. Exp Eye Res, 2020, 197: 108103[2020-06-06]. https://pubmed.ncbi.nlm.nih.gov/32522476/. DOI: 10.1016/j.exer.2020.108103.
2.	劉曉晴, 周雪美, 原慧萍. 青光眼對視神經篩板的影響[J]. 眼科學報, 2020, 35(6): 436-441. DOI: 10.3978/j.issn.1000-4432.2020.12.11.Liu XQ, Zhou XM, Yuan HP. Effect of glaucoma on optic nerve lamina cribrosa[J]. Yan Ke Xue Bao, 2020, 35(6): 436-441. DOI: 10.3978/j.issn.1000-4432.2020.12.11.
3.	王余萍, 袁源智. 青光眼視神經損害機制[J]. 中國臨床醫學, 2016, 23(5): 667-671. DOI: 10.12025/j.issn.1008-6358.2016.20160290.Wang YP, Yuan YZ. The mechanism of optic nerve damage in glaucoma[J]. Chinese Journal of Clinical Medicine, 2016, 23(5): 667-671. DOI: 10.12025/j.issn.1008-6358.2016.20160290.
4.	張純, 吳倩如, 張頔, 等. 青光眼性視神經損傷的非壓力依賴因素[J]. 中華眼科雜志, 2020, 56(7): 549-556. DOI: 10.3760/cma.j.cn112142-20190922-00480.Zhang C, Wu QR, Zhang D, et al. Non-pressure dependent factors of glaucomatous optic nerve injury[J]. Chinese J Ophthalmol, 2020, 56(7): 549-556. DOI: 10.3760/cma.j.cn112142-20190922-00480.
5.	劉旭陽, 樊寧. 局灶性篩板缺損對青光眼進展的影響[J]. 中華眼科雜志, 2020, 56(1): 17-20. DOI: 10.3760/cma.j.issn.0412-4081.2020.01.007.Liu XY, Fan N. The effect of focal lamina defect on the progression of glaucoma[J]. Chin J Ophthalmol, 2020, 56(1): 17-20. DOI: 10.3760/cma.j.issn.0412-4081.2020.01.007.
6.	杜紹林, 鄭文凱, 董秀清, 等. 青光眼角膜生物力學與視盤生物力學的關系[J]. 中山大學學報(醫學版), 2019, 40(6): 938-945. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0129.Du SL, Zheng WK, Dong XQ, et al. The relationship between corneal biomechanics and optic disc biomechanics in glaucoma[J]. Journal of Sun Yat-sen University(Medical Sciences), 2019, 40(6): 938-945. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0129.
7.	吳建, 王寧利. 篩板結構及影像學研究進展[J]. 國際眼科縱覽, 2019, 43(5): 300-305. DOI: 10.3760/cma.j.issn.1673-5803.2019.05.003.Wu J, Wang NL. Research advances in structure and imaging of lamina cribrosa[J]. Int Rev Ophthalmol, 2019, 43(5): 300-305. DOI: 10.3760/cma.j.issn.1673-5803.2019.05.003.
8.	張婷, 李龍, 宋凡. 青光眼發病機理—篩板變形研究進展[J]. 力學學報, 2019, 51(5): 1273-1284. DOI: 10.6052/0459-1879-18-321.Zhang T, Li L, Song F. The pathogenesis of glaucoma—research progress on sieve plate deformation of lamina cribrosa[J]. Chinese Journal of Theoretical and Applied Mechanics, 2019, 51(5): 1273-1284. DOI: 10.6052/0459-1879-18-321.
9.	張地, 劉向玲, 宋子宣, 等. 原發性急性閉角型青光眼大發作緩解后視盤參數變化[J]. 眼科新進展, 2019, 39(7): 682-685. DOI: 10.13389/j.cnki.rao.2019.0157.Zhang D, Liu XL, Song ZX, et al. Changes in optic disc parameters after remission from a major attack of acute angle-closure glaucoma[J]. Rec Adv Ophthalmol, 2019, 39(7): 682-685. DOI: 10.13389/j.cnki.rao.2019.0157.
10.	李略, 卞愛玲, 程鋼煒, 等. 增強深部成像相干光斷層掃描術觀察原發性開角型青光眼視乳頭篩板的形態學變化[J]. 中華眼科雜志, 2016, 52(6): 422-428. DOI: 10.3760/cma.j.issn.0412-4081.2016.06.006.Li L, Bian AL, Cheng GW, et al. Analysis of morphologic changes of lamina cribrosa in primary open angle glaucoma using enhanced depth imaging optical coherence tomography[J]. Chin J Ophthalmol, 2016, 52(6): 422-428. DOI: 10.3760/cma.j.issn.0412-4081.2016.06.006.
11.	孫云曉, 謝媛, 劉祥祥, 等. 自發性局限性篩板缺損與青光眼視神經損傷進展的關系[J]. 中華眼科雜志, 2019, 55(5): 338-346. DOI: 10.3760/cma.j.issn.0412-4081.2019.05.007.Sun YX, Xie Y, Liu XX, et al. Spontaneous focal lamina cribrosa defect in glaucoma and its relationship with nonprogressive glaucomatous neuropathy[J]. Chin J Ophthalmol, 2019, 55(5): 338-346. DOI: 10.3760/cma.j.issn.0412-4081.2019.05.007.
12.	Sun Y, Guo Y, Cao K, et al. Relationship between corneal stiffness parameters and lamina cribrosa curvature in normal tension glaucoma[J/OL]. Eur J Ophthalmol, 2020, 18: 1120672120982521[2020-12-18]. https://pubmed.ncbi.nlm.nih.gov/33334173/. DOI: 10.1177/1120672120982521.
13.	中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年)[J]. 中華眼科雜志, 2014, 50(5): 382-383. DOI: 10.3760/cma.j.issn.0412-4081.2014.05.022.Glaucoma Group, Ophthalmology Branch of Chinese Medical Association. Expert consensus on the diagnosis and treatment of primary glaucoma in my country (2014)[J]. Chin J Ophthalmol, 2014, 50(5): 382-383. DOI: 10.3760/cma.j.issn.0412-4081.2014.05.022.
14.	Won HJ, Sung KR, Shin JW, et al. Comparison of lamina cribrosa curvature in pseudoexfoliation and primary open-angle glaucoma[J]. Am J Ophthalmol, 2021, 223: 1-8. DOI: 10.1016/j.ajo.2020.09.028.
15.	Kim JA, Lee EJ, Kim TW, et al. Differentiation of nonarteritic anterior ischemic optic neuropathy from normal tension glaucoma by comparison of the lamina cribrosa[J/OL]. Invest Ophthalmol Vis Sci, 2020, 61(8): 21[2020-07-01]. https://pubmed.ncbi.nlm.nih.gov/32668001/. DOI: 10.1167/iovs.61.8.21.
16.	Loiselle AR, Kleine E, Van DP, et al. Intraocular and intracranial pressure in glaucoma patients taking acetazolamide[J/OL]. PloS one, 2020, 15(6): e0234690[2020-08-18]. https://pubmed.ncbi.nlm.nih.gov/32555666/. DOI: 10.1371/journal.pone.0234690.
17.	肖春婷, 吳瑜瑜. 篩板青光眼性病理及跨篩板壓力差在視神經損害中研究進展[J]. 中國實用眼科雜志, 2015, 33(4): 332-336. DOI: 10.3760/cma.j.issn.1006-4443.2015.04.002.Xiao CT, Wu YY. Research progress of lamina glaucoma pathology and transmembrane pressure difference in optic nerve damage[J]. Chin J of Pract Ophthalmol, 2015, 33(4): 332-336. DOI: 10.3760/cma.j.issn.1006-4443.2015.04.002.
18.	郝琳琳, 肖輝, 陳翔熙, 等. 原發性開角型青光眼與原發性慢性閉角型青光眼活體篩板厚度和篩板前表面深度的比較[J]. 中華眼底病雜志, 2016, 32(6): 619-623. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.013.Hao LL, Xiao H, Chen XX, et al. Comparing the lamina cribrosa in eyes with primary open angle glaucoma and chronic primary angle closure glaucoma[J]. Chin J Ocular Fundus Dis, 2016, 32(6): 619-623. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.013.
19.	Sun Y, Guo Y, Xie Y, et al. Inter-eye comparison of focal lamina cribrosa defect in normal tension glaucoma patients with asymmetric visual field loss[J/OL]. Ophthalmic Res, 2020,2020:E1[2020-11-10].https://doi.org/10.1159/000512925.DOI: 10.1159/000512925. [published online ahead of print].
20.	Hopkins AA, Murphy R, Irnaten M, et al. The role of lamina cribrosa tissue stiffness and fibrosis as fundamental biomechanical drivers of pathological glaucoma cupping[J]. Am J Physiol Cell Physiol, 2020, 319(4): C1258-C1233. DOI: 10.1152/ajpcell.00054.2020.

1. Lopez NN, Clark AF, Tovar-Vidales T. Isolation and characterization of human optic nerve head astrocytes and lamina cribrosa cells[J/OL]. Exp Eye Res, 2020, 197: 108103[2020-06-06]. https://pubmed.ncbi.nlm.nih.gov/32522476/. DOI: 10.1016/j.exer.2020.108103.
2. 劉曉晴, 周雪美, 原慧萍. 青光眼對視神經篩板的影響[J]. 眼科學報, 2020, 35(6): 436-441. DOI: 10.3978/j.issn.1000-4432.2020.12.11.Liu XQ, Zhou XM, Yuan HP. Effect of glaucoma on optic nerve lamina cribrosa[J]. Yan Ke Xue Bao, 2020, 35(6): 436-441. DOI: 10.3978/j.issn.1000-4432.2020.12.11.
3. 王余萍, 袁源智. 青光眼視神經損害機制[J]. 中國臨床醫學, 2016, 23(5): 667-671. DOI: 10.12025/j.issn.1008-6358.2016.20160290.Wang YP, Yuan YZ. The mechanism of optic nerve damage in glaucoma[J]. Chinese Journal of Clinical Medicine, 2016, 23(5): 667-671. DOI: 10.12025/j.issn.1008-6358.2016.20160290.
4. 張純, 吳倩如, 張頔, 等. 青光眼性視神經損傷的非壓力依賴因素[J]. 中華眼科雜志, 2020, 56(7): 549-556. DOI: 10.3760/cma.j.cn112142-20190922-00480.Zhang C, Wu QR, Zhang D, et al. Non-pressure dependent factors of glaucomatous optic nerve injury[J]. Chinese J Ophthalmol, 2020, 56(7): 549-556. DOI: 10.3760/cma.j.cn112142-20190922-00480.
5. 劉旭陽, 樊寧. 局灶性篩板缺損對青光眼進展的影響[J]. 中華眼科雜志, 2020, 56(1): 17-20. DOI: 10.3760/cma.j.issn.0412-4081.2020.01.007.Liu XY, Fan N. The effect of focal lamina defect on the progression of glaucoma[J]. Chin J Ophthalmol, 2020, 56(1): 17-20. DOI: 10.3760/cma.j.issn.0412-4081.2020.01.007.
6. 杜紹林, 鄭文凱, 董秀清, 等. 青光眼角膜生物力學與視盤生物力學的關系[J]. 中山大學學報(醫學版), 2019, 40(6): 938-945. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0129.Du SL, Zheng WK, Dong XQ, et al. The relationship between corneal biomechanics and optic disc biomechanics in glaucoma[J]. Journal of Sun Yat-sen University(Medical Sciences), 2019, 40(6): 938-945. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2019.0129.
7. 吳建, 王寧利. 篩板結構及影像學研究進展[J]. 國際眼科縱覽, 2019, 43(5): 300-305. DOI: 10.3760/cma.j.issn.1673-5803.2019.05.003.Wu J, Wang NL. Research advances in structure and imaging of lamina cribrosa[J]. Int Rev Ophthalmol, 2019, 43(5): 300-305. DOI: 10.3760/cma.j.issn.1673-5803.2019.05.003.
8. 張婷, 李龍, 宋凡. 青光眼發病機理—篩板變形研究進展[J]. 力學學報, 2019, 51(5): 1273-1284. DOI: 10.6052/0459-1879-18-321.Zhang T, Li L, Song F. The pathogenesis of glaucoma—research progress on sieve plate deformation of lamina cribrosa[J]. Chinese Journal of Theoretical and Applied Mechanics, 2019, 51(5): 1273-1284. DOI: 10.6052/0459-1879-18-321.
9. 張地, 劉向玲, 宋子宣, 等. 原發性急性閉角型青光眼大發作緩解后視盤參數變化[J]. 眼科新進展, 2019, 39(7): 682-685. DOI: 10.13389/j.cnki.rao.2019.0157.Zhang D, Liu XL, Song ZX, et al. Changes in optic disc parameters after remission from a major attack of acute angle-closure glaucoma[J]. Rec Adv Ophthalmol, 2019, 39(7): 682-685. DOI: 10.13389/j.cnki.rao.2019.0157.
10. 李略, 卞愛玲, 程鋼煒, 等. 增強深部成像相干光斷層掃描術觀察原發性開角型青光眼視乳頭篩板的形態學變化[J]. 中華眼科雜志, 2016, 52(6): 422-428. DOI: 10.3760/cma.j.issn.0412-4081.2016.06.006.Li L, Bian AL, Cheng GW, et al. Analysis of morphologic changes of lamina cribrosa in primary open angle glaucoma using enhanced depth imaging optical coherence tomography[J]. Chin J Ophthalmol, 2016, 52(6): 422-428. DOI: 10.3760/cma.j.issn.0412-4081.2016.06.006.
11. 孫云曉, 謝媛, 劉祥祥, 等. 自發性局限性篩板缺損與青光眼視神經損傷進展的關系[J]. 中華眼科雜志, 2019, 55(5): 338-346. DOI: 10.3760/cma.j.issn.0412-4081.2019.05.007.Sun YX, Xie Y, Liu XX, et al. Spontaneous focal lamina cribrosa defect in glaucoma and its relationship with nonprogressive glaucomatous neuropathy[J]. Chin J Ophthalmol, 2019, 55(5): 338-346. DOI: 10.3760/cma.j.issn.0412-4081.2019.05.007.
12. Sun Y, Guo Y, Cao K, et al. Relationship between corneal stiffness parameters and lamina cribrosa curvature in normal tension glaucoma[J/OL]. Eur J Ophthalmol, 2020, 18: 1120672120982521[2020-12-18]. https://pubmed.ncbi.nlm.nih.gov/33334173/. DOI: 10.1177/1120672120982521.
13. 中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年)[J]. 中華眼科雜志, 2014, 50(5): 382-383. DOI: 10.3760/cma.j.issn.0412-4081.2014.05.022.Glaucoma Group, Ophthalmology Branch of Chinese Medical Association. Expert consensus on the diagnosis and treatment of primary glaucoma in my country (2014)[J]. Chin J Ophthalmol, 2014, 50(5): 382-383. DOI: 10.3760/cma.j.issn.0412-4081.2014.05.022.
14. Won HJ, Sung KR, Shin JW, et al. Comparison of lamina cribrosa curvature in pseudoexfoliation and primary open-angle glaucoma[J]. Am J Ophthalmol, 2021, 223: 1-8. DOI: 10.1016/j.ajo.2020.09.028.
15. Kim JA, Lee EJ, Kim TW, et al. Differentiation of nonarteritic anterior ischemic optic neuropathy from normal tension glaucoma by comparison of the lamina cribrosa[J/OL]. Invest Ophthalmol Vis Sci, 2020, 61(8): 21[2020-07-01]. https://pubmed.ncbi.nlm.nih.gov/32668001/. DOI: 10.1167/iovs.61.8.21.
16. Loiselle AR, Kleine E, Van DP, et al. Intraocular and intracranial pressure in glaucoma patients taking acetazolamide[J/OL]. PloS one, 2020, 15(6): e0234690[2020-08-18]. https://pubmed.ncbi.nlm.nih.gov/32555666/. DOI: 10.1371/journal.pone.0234690.
17. 肖春婷, 吳瑜瑜. 篩板青光眼性病理及跨篩板壓力差在視神經損害中研究進展[J]. 中國實用眼科雜志, 2015, 33(4): 332-336. DOI: 10.3760/cma.j.issn.1006-4443.2015.04.002.Xiao CT, Wu YY. Research progress of lamina glaucoma pathology and transmembrane pressure difference in optic nerve damage[J]. Chin J of Pract Ophthalmol, 2015, 33(4): 332-336. DOI: 10.3760/cma.j.issn.1006-4443.2015.04.002.
18. 郝琳琳, 肖輝, 陳翔熙, 等. 原發性開角型青光眼與原發性慢性閉角型青光眼活體篩板厚度和篩板前表面深度的比較[J]. 中華眼底病雜志, 2016, 32(6): 619-623. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.013.Hao LL, Xiao H, Chen XX, et al. Comparing the lamina cribrosa in eyes with primary open angle glaucoma and chronic primary angle closure glaucoma[J]. Chin J Ocular Fundus Dis, 2016, 32(6): 619-623. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.013.
19. Sun Y, Guo Y, Xie Y, et al. Inter-eye comparison of focal lamina cribrosa defect in normal tension glaucoma patients with asymmetric visual field loss[J/OL]. Ophthalmic Res, 2020,2020:E1[2020-11-10].https://doi.org/10.1159/000512925.DOI: 10.1159/000512925. [published online ahead of print].
20. Hopkins AA, Murphy R, Irnaten M, et al. The role of lamina cribrosa tissue stiffness and fibrosis as fundamental biomechanical drivers of pathological glaucoma cupping[J]. Am J Physiol Cell Physiol, 2020, 319(4): C1258-C1233. DOI: 10.1152/ajpcell.00054.2020.

Chinese Journal of Ocular Fundus Diseases

Comparison and significance of scleral cribriform curvature in different types of glaucoma

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