Biomechanical Properties of Bruch's Membrane–Choroid Complex and Their Influence on Optic Nerve Head Biomechanics

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.

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The use of Bruch's membrane opening-based optical coherence tomography of the optic nerve head for glaucoma detection in microdiscs

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2016-308957 ◽

2016 ◽

Vol 101 (4) ◽

pp. 530-535 ◽

Cited By ~ 20

Author(s):

Philip Enders ◽

Friederike Schaub ◽

Werner Adler ◽

Roman Nikoluk ◽

Manuel M Hermann ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Nerve ◽

Optic Nerve Head ◽

Optical Coherence ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Glaucoma Detection ◽

Bruch’S Membrane Opening

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Offset of openings in optic nerve head canal at level of Bruch’s membrane, anterior sclera, and lamina cribrosa

Scientific Reports ◽

10.1038/s41598-021-01184-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kyoung Min Lee ◽

Hyoung Jun Ahn ◽

Martha Kim ◽

Sohee Oh ◽

Seok Hwan Kim

Keyword(s):

Optic Nerve ◽

Optic Nerve Head ◽

Lamina Cribrosa ◽

Angular Deviation ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Bruch’S Membrane Opening

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.

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Offset of Openings in Optic Nerve Head Canal at Level of Bruch’s Membrane, Anterior Sclera, and Lamina Cribrosa

10.21203/rs.3.rs-384521/v1 ◽

2021 ◽

Author(s):

Kyoung Min Lee ◽

Hyoung Jun Ahn ◽

Martha Kim ◽

Sohee Oh ◽

Seok Hwan Kim

Keyword(s):

Optic Nerve ◽

Optic Nerve Head ◽

Lamina Cribrosa ◽

Angular Deviation ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Bruch’S Membrane Opening

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.

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Bruch’s membrane opening-based optical coherence tomography of the optic nerve head: a useful diagnostic tool to detect glaucoma in macrodiscs

Eye ◽

10.1038/eye.2017.306 ◽

2018 ◽

Vol 32 (2) ◽

pp. 314-323 ◽

Cited By ~ 13

Author(s):

P Enders ◽

F Schaub ◽

W Adler ◽

M M Hermann ◽

T S Dietlein ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Nerve ◽

Optic Nerve Head ◽

Diagnostic Tool ◽

Optical Coherence ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Bruch’S Membrane Opening

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Predictors of radio-induced visual impairment after radiosurgery for uveal melanoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310801 ◽

2017 ◽

Vol 102 (6) ◽

pp. 833-839 ◽

Cited By ~ 5

Author(s):

Carmen Rosaria Gigliotti ◽

Giulio Modorati ◽

Maura Di Nicola ◽

Claudio Fiorino ◽

Lucia Alessia Perna ◽

...

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Side Effects ◽

Uveal Melanoma ◽

Three Dimensional ◽

Neovascular Glaucoma ◽

Posterior Segment ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Membrane Rupture

AimsThe aim of the present work is to assess the main predictors of the most clinically relevant radio-induced effects after Gamma Knife stereotactic radiosurgery (GKRS) for uveal melanoma (UM).Materials and methodsMedical records and three-dimensional dosimetry data of critical structures of 66 patients were retrospectively reviewed. Cox’s proportional hazard model was used to identify clinical and dosimetric variables as independent risk factor for GKRS-related complications.ResultsThe fraction of the posterior segment receiving more than 20Gy (V20), Bruch’s membrane rupture and tumour thickness were significant prognostic factors for neovascular glaucoma. A clear relationship with the dose received by 1% of the optic nerve (D1%) was found for radiation retinopathy and papillopathy. Multivariables models resulted for visual acuity (VA) reduction >20% of the basal value and for complete VA loss, both including largest tumour diameter and D1% to the optic nerve. The predictive model for complete VA loss includes also Bruch’s membrane rupture. An alternative model for complete visual acuity loss, including the optic nerve-prescription isodose minimum distance, was also suggested.ConclusionsWe found clinical and dosimetric variables to clearly predict the risk of the main side effects after GKRS for UM. These results may provide dose constraints to critical structures, potentially able to reduce side effects. Constraining D1% to the optic nerve below 12-13Gy may result in a dramatic reduction of blindness risk, while reducing V20 of the posterior segment of the bulb could limit the neovascular glaucoma onset.

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Relationship between Corneal Biomechanical Properties and Optic Nerve Head Changes after Deep Sclerectomy

European Journal of Ophthalmology ◽

10.5301/ejo.5000955 ◽

2017 ◽

Vol 27 (5) ◽

pp. 535-541 ◽

Cited By ~ 9

Author(s):

Laura Díez-Álvarez ◽

Francisco J. Muñoz-Negrete ◽

Pilar Casas-Llera ◽

Noelia Oblanca ◽

Victoria de Juan ◽

...

Keyword(s):

Optic Nerve ◽

Optic Nerve Head ◽

Open Angle Glaucoma ◽

Biomechanical Properties ◽

Resistance Factor ◽

Corneal Hysteresis ◽

Enhanced Depth Imaging ◽

Deep Sclerectomy ◽

Corneal Resistance Factor ◽

Corneal Biomechanical Properties

Purpose To evaluate corneal biomechanical properties and optic nerve head (ONH) changes following deep sclerectomy (DS) and the relation to each other. Methods Forty-nine eyes with primary open-angle glaucoma that underwent DS were studied. Corneal biomechanical properties were assessed using the Ocular Response Analyzer and the ONH was evaluated by Spectralis optical coherence tomography with enhanced depth imaging technology before surgery and 3 months postoperatively. Changes in corneal hysteresis (CH), corneal resistance factor (CRF), optic nerve cupping, prelaminar tissue thickness, and lamina cribrosa depth and thickness were registered. A correlation matrix and multiple linear regression models were used to determine predictors of ONH changes. Results At 3 months after surgery, mean corneal compensated intraocular pressure (IOPcc) significantly decreased by 27.9% (p<00.001) and mean Goldmann-correlated IOP (IOPg) decreased by 30.52% (p<00.001). Mean CH increased and CRF decreased by 18.4% and 10.1%, respectively (p<00.001). There was a significant reversal of ONH cupping mainly due to a prelaminar tissue thickening (p<00.001). Significant associations were found between ONH cupping reversal and prelaminar tissue thickening with preoperative IOPcc (p = 0.046), IOPg (p = 0.02), and CRF (p = 0.002) and with changes in IOP, CH, and CRF (p<00.001, p = 0.004, p = 0.018, respectively) after surgery. Conclusions Corneal hysteresis increased and CRF decreased significantly 3 months after DS. Corneal resistance factor was the single largest preoperative factor influencing cupping reversal changes. Despite the influence of preoperative variables, postoperative IOP reduction was the only independent factor influencing changes observed in the ONH after surgery.

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Pattern Electroretinogram Parameters Are Associated with Optic Nerve Morphology in Preperimetric Glaucoma after Adjusting for Disc Area

Journal of Ophthalmology ◽

10.1155/2021/8025337 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Andrew Tirsi ◽

Vasiliki Gliagias ◽

Julie Moehringer ◽

Derek Orshan ◽

Sofia Tello ◽

...

Keyword(s):

Optic Nerve ◽

Retinal Nerve Fiber Layer ◽

Pattern Electroretinogram ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Fiber Layer ◽

Disc Area ◽

Preperimetric Glaucoma ◽

Bruch’S Membrane Opening ◽

Retinal Nerve Fiber

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.

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