scholarly journals Bruch’s membrane opening enlargement and its implication on the myopic optic nerve head

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mi Sun Sung ◽  
Min Young Heo ◽  
Hwan Heo ◽  
Sang Woo Park

AbstractWe examined the association between Bruch’s membrane opening (BMO) area and various ocular parameters and investigated the implication of BMO enlargement on the myopic optic nerve head. One hundred eighty-five myopic eyes were included in this cross-sectional study. Among the included eyes, 53 having axial lengths between 26 and 27 mm were further analyzed to investigate the association between BMO area and various ocular parameters. BMO area, BMO-minimum rim width (BMO-MRW), peripapillary choroidal thickness (pCT), width of β-parapapillary atrophy with and without Bruch’s membrane (PPA+BM and PPA−BM), and presence of lamina cribrosa (LC) defect were evaluated. We found that BMO area tended to increase with increasing axial length, but varied among the highly myopic eyes even though they had similar degrees of myopia. In the subgroup analysis of eyes with axial lengths between 26 and 27 mm, BMO area was highly variable and it significantly correlated with PPA−BM width and temporal-inferior, nasal-inferior, and nasal BMO-MRW and pCT. LC defects were more common in myopic eyes with enlarged BMO. A multivariate regression model revealed that higher intraocular pressure, enlarged BMO, and thinner BMO-MRW were associated with LC defects in highly myopic eyes. These findings should be considered when evaluating myopic eyes.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoung Min Lee ◽  
Hyoung Jun Ahn ◽  
Martha Kim ◽  
Sohee Oh ◽  
Seok Hwan Kim

AbstractWe compared the central retinal vascular trunk (CRVT) position, as a surrogate of lamina cribrosa (LC) offset, with the anterior scleral opening (ASCO) offset from the Bruch’s membrane opening (BMO). Based on the BMO-centered radial scans, the BMO and ASCO margins were demarcated, and each center was determined as the center of the best-fitted ellipse for each margin. The ASCO/BMO offset was defined as the offset between each center. Angular deviations and the extent of ASCO and CRVT offsets from the BMO center were compared directly. Incomplete demarcation of ASCO was found in 20%, which was associated with a larger BMO area and a larger ASCO offset from the BMO. The angular deviation of ASCO offset was associated with that of CRVT offset and that of the longest externally oblique border. The ASCO offset was smaller than the CRVT offset, and, unlike the CRVT offset, it was rarely deviated to the inferior side. The complete ASCO margin might not be demarcatable when determined on BMO-centered radial scans in the presence of an offset. Also, the ASCO, which reflects only the superficial scleral layer, might not reflect the LC position, because the LC might be shifted further from the ASCO.


2021 ◽  
Author(s):  
Kyoung Min Lee ◽  
Hyoung Jun Ahn ◽  
Martha Kim ◽  
Sohee Oh ◽  
Seok Hwan Kim

Abstract We compared the central retinal vascular trunk (CRVT) position, as a surrogate of lamina cribrosa (LC) offset, with the anterior scleral opening (ASCO) offset from the Bruch’s membrane opening (BMO). Based on the BMO-centered radial scans, the BMO and ASCO margins were demarcated, and each center was determined as the center of the best-fitted ellipse for each margin. The ASCO/BMO offset was defined as the offset between each center. Angular deviations and the extent of ASCO and CRVT offsets from the BMO center were compared directly. Incomplete demarcation of ASCO was found in 20%, which was associated with a larger BMO area and a larger ASCO offset from the BMO. The angular deviation of ASCO offset was associated with that of CRVT offset and that of the longest externally oblique border. The ASCO offset was smaller than the CRVT offset, and, unlike the CRVT offset, it was rarely deviated to the inferior side. The complete ASCO margin might not be demarcateable when determined on BMO-centered radial scans in the presence of an offset. Also, the ASCO, which reflects only the superficial scleral layer, might not reflect the LC position, because the LC might be shifted further from the ASCO.


2018 ◽  
Vol 103 (10) ◽  
pp. 1401-1405
Author(s):  
Lucas A Torres ◽  
Faisal Jarrar ◽  
Glen P Sharpe ◽  
Donna M Hutchison ◽  
Eduardo Ferracioli-Oda ◽  
...  

Background/aimsOptical coherence tomography (OCT) imaging of the optic nerve head minimum rim width (MRW) has recently been shown to sometimes contain components besides extended retinal nerve fibre layer (RNFL). This study was conducted to determine whether excluding these components, termed protruded retinal layers (PRLs), from MRW increases diagnostic accuracy for detecting glaucoma.MethodsIn this cross-sectional study, we included 123 patients with glaucoma and 123 normal age-similar controls with OCT imaging of the optic nerve head (24 radial scans) and RNFL (circle scan). When present, PRLs were manually segmented, and adjusted MRW measurements were computed. We compared diagnostic accuracy of adjusted versus unadjusted MRW measurement. We also determined whether adjusted MRW correlates better with RNFL thickness compared with unadjusted MRW.ResultsThe median (IQR) visual field mean deviation of patients and controls was −4.4 (−10.3 to −2.1) dB and 0.0 (−0.6 to 0.8) dB, respectively. In the 5904 individual B-scans, PRLs were identified less frequently in patients (448, 7.6%) compared with controls (728, 12.3%; p<0.01) and were present most frequently in the temporal sector of both groups. Areas under the receiver operating characteristic curves and sensitivity values at 95% specificity indicated that PRL adjustment did not improve diagnostic accuracy of MRW, globally or temporally. Furthermore, adjusting MRW for PRL did not improve its correlation with RNFL thickness in either group.ConclusionWhile layers besides the RNFL are sometimes included in OCT measurements of MRW, subtracting these layers does not impact clinical utility.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Andrew Tirsi ◽  
Vasiliki Gliagias ◽  
Julie Moehringer ◽  
Derek Orshan ◽  
Sofia Tello ◽  
...  

Purpose. We examined the relationships between pattern electroretinogram and optical coherence tomography derived optic nerve head measurements, after controlling for disc area. Methods. Thirty-two eyes from 20 subjects with preperimetric glaucoma underwent pattern electroretinogram and optical coherence tomography. Pattern electroretinogram parameters (Magnitude, MagnitudeD, and MagnitudeD/Magnitude ratio) and optic nerve head measurements (rim area, average cup to disc ratio, vertical cup to disc ratio, cup volume, retinal nerve fiber layer thickness sectors, and Bruch’s membrane opening-minimum rim width thickness sectors) were analyzed after controlling for disc area. Results. Magnitude and MagnitudeD were significantly associated with rim area (r ≥ 0.503, p ≤ 0.004 ). All pattern electroretinogram parameters significantly correlated with Bruch’s membrane opening-minimum rim width sectors—temporal superior and nasal inferior (r = 0.400, p = 0.039 )—and retinal nerve fiber layer sectors—superior, nasal superior, and inferior (r ≥ 0.428, p ≤ 0.026 ). Magnitude and MagnitudeD explained an additional 26.8% and 25.2% of variance in rim area (B = 0.174 (95% CI: 0.065, 0.283), p = 0.003 , and B = 0.160 (95% CI: 0.056, 0.265), p = 0.004 ), respectively. MagnitudeD and MagnitudeD/Magnitude ratio explained an additional 13.4% and 12.8% of the variance in Bruch’s membrane opening-minimum rim width global (B = 38.921 [95% CI: 3.872, 73.970], p = 0.031 , and B = 129.024 (95% CI: 9.589, 248.460), p = 0.035 ), respectively. All Bruch’s membrane opening-minimum rim width sectors and retinal nerve fiber layer sectors (nasal superior, nasal inferior, and inferior) were significantly correlated with rim area (r ≥ 0.389, p ≤ 0.045 ). Conclusion. PERG abnormalities can predict rim area loss in preperimetric glaucoma after controlling for disc area. We recommend controlling for disc area to increase diagnostic accuracy in early glaucoma.


Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Masoud Mehrpour ◽  
Fatemeh Oliaee Torshizi ◽  
Shooka Esmaeeli ◽  
Salameh Taghipour ◽  
Sahar Abdollahi

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination.Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes.Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100% for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90% for the right eye and 87% for the left eye.Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage.


2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
F. Saenz-Frances ◽  
L. Jañez ◽  
C. Berrozpe-Villabona ◽  
L. Borrego-Sanz ◽  
L. Morales-Fernández ◽  
...  

Purpose. To study whether a corneal thickness segmentation model, consisting in a central circular zone of 1 mm radius centered at the corneal apex (zone I) and five concentric rings of 1 mm width (moving outwards: zones II to VI), could boost the diagnostic accuracy of Heidelberg Retina Tomograph’s (HRT’s) MRA and GPS.Material and Methods. Cross-sectional study. 121 healthy volunteers and 125 patients with primary open-angle glaucoma. Six binary multivariate logistic regression models were constructed (MOD-A1, MOD-A2, MOD-B1, MOD-B2, MOD-C1, and MOD-C2). The dependent variable was the presence of glaucoma. In MOD-A1, the predictor was the result (presence of glaucoma) of the analysis of the stereophotography of the optic nerve head (ONH). In MOD-B1 and MOD-C1, the predictor was the result of the MRA and GPS, respectively. In MOD-B2 and MOD-C2, the predictors were the same along with corneal variables: central, overall, and zones I to VI thicknesses. This scheme was reproduced for model MOD-A2 (stereophotography along with corneal variables). Models were compared using the area under the receiver operator characteristic curve (AUC).Results. MOD-A1-AUC: 0.771; MOD-A2-AUC: 0.88; MOD-B1-AUC: 0.736; MOD-B2-AUC: 0.845; MOD-C1-AUC: 0.712; MOD-C2-AUC: 0.838.Conclusion. Corneal thickness variables enhance ONH assessment and HRT’s MRA and GPS diagnostic capacity.


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