Bruch's membrane opening – minimum rim width measurement after acute primary angle-closure

2021 ◽  
pp. 112067212110549
Author(s):  
Gabriel Ayub ◽  
Vital Paulino Costa ◽  
José Paulo Cabral de Vasconcellos
Keyword(s):  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Strong Positive Correlation ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Fiber Layer ◽  
Strong Negative Correlation ◽  
Acute Primary Angle Closure ◽  
Primary Angle Closure ◽  
Bruch’S Membrane Opening

Purpose To evaluate Bruch's membrane opening – minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer thickness (RNFLT) following an acute primary angle-closure attack (APAC). Materials and methods Nine consecutive patients with unilateral APAC were included. Patients with a bilateral attack, with signs of glaucomatous optic nerve damage or evidence of a previous APAC in either eye were excluded. Three months after the attack, all eyes underwent BMO-MRW and RNFLT measurements with SDOCT. APAC eyes were compared to the contralateral eyes. Results Three months after the attack, mean BMO-MRWs were 281.22 ± 56.88 μm and 313.78 ± 43.48 μm ( P = 0.009) and mean RNFLTs were 78 ± 15.36 μm vs 95.78 ± 10.81 μm ( P = 0.008) in the APAC and contralateral eyes, respectively. RNFLT and BMO-MRW measurements had a strong positive correlation ( R = 0.7436, P = 0.013). APAC eyes had a shorter axial length (21.85 ± 1.21 vs 22 ± 1.07, P = 0.042) and shallower anterior chamber depth (2.29 ± 0.21 vs 2.41 ± 0.12, P = 0.039) than contralateral eyes. IOP at presentation showed a strong negative correlation with both BMO-MRW ( R = −0.7669, P = 0.009) and RNFLT measurements ( R = −0.7723, P = 0.008). Conclusion BMO-MRW and RNFLT measurements are significantly reduced 3 months after an APAC when compared to the contralateral eye. IOP at presentation may have an impact on the reduction of these parameters.

scholarly journals Factors Associated with Increased Neuroretinal Rim Thickness Measured Based on Bruch’s Membrane Opening-Minimum Rim Width after Trabeculectomy

2021 ◽  
Vol 10 (16) ◽  
pp. 3646
Author(s):  
Do-Young Park ◽  
Soon-Cheol Cha
Keyword(s):  
Open Angle Glaucoma ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Fiber Layer ◽  
Factors Associated ◽  
Nerve Fiber Layer Thickness ◽  
Neuroretinal Rim ◽  
Before And After ◽  
Bruch’S Membrane Opening ◽  
Sd Oct

Purpose: To investigate the factors associated with an increase in the neuroretinal rim (NRR) thickness measured based on Bruch’s membrane opening-minimum rim width (BMO-MRW) after trabeculectomy in patients with primary open-angle glaucoma (POAG). Methods: We analyzed the BMO-MRW using spectral-domain optical coherence tomography (SD-OCT) of patients with POAG who underwent a trabeculectomy for uncontrolled intraocular pressure (IOP) despite maximal IOP reduction treatment. The BMO-MRW was measured before and after trabeculectomy in patients with POAG. Demographic and systemic factors, ocular factors, pre- and post-operative IOP, and visual field parameters were collected, together with SD-OCT measurements. A regression analysis was performed to investigate the factors that affected the change in the BMO-MRW after the trabeculectomy. Results: Forty-four eyes of 44 patients were included in the analysis. The IOP significantly decreased from a preoperative 27.0 mmHg to a postoperative 10.5 mmHg. The mean interval between the trabeculectomy and the date of post-operative SD-OCT measurement was 3.3 months. The global and sectoral BMO-MRW significantly increased after trabeculectomy, whereas the peripapillary retinal nerve fiber layer thickness did not show a difference between before and after the trabeculectomy. Younger age and a greater reduction in the IOP after the trabeculectomy were significantly associated with the increase in the BMO-MRW after trabeculectomy. Conclusions: The NRR thickness measured based on the BMO-MRW increased with decreasing IOP after trabeculectomy, and the increase in the BMO-MRW was associated with the young age of the patients and greater reduction in the IOP after trabeculectomy. Biomechanically, these suggest that the NRR comprises cells and substances that sensitively respond to changes in the IOP and age.

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

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.

scholarly journals Normal Tension Primary Ppen-Angle Glaucoma with Progressive Synechial Angle Closure in Senior Chinese

2021 ◽  
Author(s):  
Zhigang Fan ◽  
Zhenni Zhao ◽  
Xiaowei Yu ◽  
Dandan Zhang ◽  
Nannan Sun ◽  
...  
Keyword(s):  
Anterior Chamber Depth ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
Mean Deviation ◽  
Glaucomatous Optic Neuropathy ◽  
Fiber Layer ◽  
Treatment Targets ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Senior Population

Abstract Background: This study is to address a unique subtype of combined-mechanism glaucoma (CMG), normal tension glaucoma (NTG) with progressive synechial angle closure in the Chinese senior population, whose clinical course and treatment targets are quite different from classic primary angle-closure glaucoma (PACG). Methods: In this retrospective study, 12 patients with NTG plus primary angle closure suspect or primary angle closure were included in the CMG group, and 12 classic PACG patients with matched extent of glaucomatous optic neuropathy (GON) were included in the control (PACG) group. Clinical features and detailed histories of disease development were investigated and compared between these two groups.Results: There were 6 females and 6 males in CMG group, 3 males and 9 females in PACG group. No statistical significances were found in age (63.42 ± 5.90 vs. 59.42 ± 7.47 years), preoperative intraocular pressure (20.75 ± 5.06 vs. 21.25 ± 4.47 mmHg), anterior chamber depth (ACD) (1.98 ± 0.28 vs. 1.94 ± 0.21mm), mean deviation of visual field (24.37 ± 6.54 vs. 22.01 ± 0.85 dB), average retinal nerve fiber layer thickness (48.00 ± 14.00 vs. 57.25 ± 14.10 μm), cup-to-disc (C/D) ratio (0.89 ± 0.07 vs. 0.87 ± 0.07) and axial length (22.69 ± 0.76 vs. 22.47 ± 0.69 mm) between the two groups (P > 0.05). The extent of synechial angle closure in PACG group was more extensive than that in CMG group, as evaluated by the number of “clock hours” (3.96 ± 1.14 vs. 9.38 ± 1.99, P < 0.05), although the severity of GON was comparable.Conclusion: If NTG develops with synechial angle closure, it might be misdiagnosed as PACG. We need to recognize and scrutinize this specific subtype of CMG, which is very common in the Chinese senior population, but widely neglected. In contrast to classic PACG, treatment targets in NTG with progressive synechial angle closure is primarily in consistent with those in NTG.

scholarly journals Rate of Change in Bruch’s Membrane Opening-Minimum Rim Width and Peripapillary RNFL in Early Normal Tension Glaucoma

2020 ◽  
Vol 9 (8) ◽  
pp. 2321
Author(s):  
Hyun-kyung Cho ◽  
Changwon Kee
Keyword(s):  
Normal Tension Glaucoma ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Fiber Layer ◽  
Acceptable Quality ◽  
Bruch’S Membrane Opening ◽  
Better Than

Background: to investigate the rate of change (ROC) of Bruch’s membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness in early normal tension glaucoma (NTG) patients. Methods: in this longitudinal cohort study, 115 subjects (115 eyes) diagnosed as early NTG (mean deviation > −6.0 dB) and who had completed more than five times of spectral-domain optical coherence tomography (OCT) tests with acceptable quality were included. Measurement of BMO-MRW and RNFL were performed at 3-month intervals by OCT. Linear mixed-effects model was employed to calculate the ROC in global region and six Garway-Heath sectors with adjusting age, sex, and BMO area. Results: Average follow-up was 20.99 ± 6.99 months with OCT number of 7.54 ± 2.12. Baseline intraocular pressure was 14.72 ± 2.70 mmHg and MD was −2.73 ± 2.26 dB. ROC of global BMO-MRW was −2.06 ± 0.65 µm/yr and RNFL was −0.96 ± 0.16 µm/yr (p = 0.098). The most rapid ROC was in inferotemporal sector (BMO-MRW: −3.02 ± 0.88 µm/yr, RNFL: −1.96 ± 0.36 µm/yr) followed by superotemporal sector. Conclusion: The ROC of BMO-MRW, the new parameter along with that of RNFL should be considered in the management of early NTG. BMO-MRW may show visible reduction ROC better than RNFL to detect early progression in early NTG when visual field may not show significant change.

Changes in retinal nerve fiber layer thickness after acute primary angle closure

Ophthalmology ◽  
2004 ◽  
Vol 111 (8) ◽  
pp. 1475-1479 ◽  
Author(s):  
Tin Aung ◽  
Rahat Husain ◽  
Gus Gazzard ◽  
Yiong-Huak Chan ◽  
Joseph G Devereux ◽  
...  
Keyword(s):  
Nerve Fiber ◽  
Layer Thickness ◽  
Retinal Nerve Fiber Layer ◽  
Angle Closure ◽  
Fiber Layer ◽  
Acute Primary Angle Closure ◽  
Nerve Fiber Layer ◽  
Primary Angle Closure ◽  
Nerve Fiber Layer Thickness ◽  
Retinal Nerve Fiber

scholarly journals Bruch’s Membrane Opening Minimum Rim Width Measurement with SD-OCT: A Method to Correct for the Opening Size of Bruch’s Membrane

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Robert Kromer ◽  
Martin Stephan Spitzer
Keyword(s):  
Optic Nerve ◽  
Internal Limiting Membrane ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Fiber Layer ◽  
Future Studies ◽  
Nerve Fiber Layer Thickness ◽  
Bruch’S Membrane Opening ◽  
The Mean ◽  
Sd Oct

A precise evaluation of the retinal nerve fiber layer thickness (RNFLT) is key for diagnosing and monitoring glaucoma. The Bruch’s membrane opening minimum rim width (BMO-MRW) has been proposed as a reproducible assessment of the optic nerve. The BMO-MRW measures the minimum distance from the BMO to the internal limiting membrane. We propose an approach to correct the BMO-MRW using the BMO size for increased accuracy in interindividual comparisons in future studies. Eighty-one healthy patients received SPECTRALIS spectral domain optical coherence tomography measurements for the peripapillary RNFLT and BMO-MRW. We calculated a BMO size-corrected BMO-MRW using the mean BMO size of our cohort. BMO size was defined using the manufacturer-provided BMO area and manually measured BMO perimeter. We observed that the BMO-MRW correlated highly with the perimeter (r=−0.553, p<0.0001) and the area of the BMO (r=−0.546, p<0.0001). Using these parameters, we provided a corrected BMO size-adjusted BMO-MRW which was better correlated with the RNFLT compared to the noncorrected one (z=−3.3495, p=0.0004). We demonstrated the dependency of the BMO-MRW on ONH size. Furthermore, we showed the superiority of the corrected BMO-MRW using either the manually measured optic nerve head perimeter or the automatically provided ONH for future studies.

scholarly journals Characteristics of Patients Showing Discrepancy Between Bruch’s Membrane Opening-Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer Thickness

2019 ◽  
Vol 8 (9) ◽  
pp. 1362 ◽  
Author(s):  
Cho ◽  
Kee
Keyword(s):  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Clinical Characteristics ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Fiber Layer ◽  
Large Disc ◽  
Nerve Fiber Layer ◽  
Bruch’S Membrane Opening ◽  
Retinal Nerve Fiber

Background: To investigate clinical characteristics of patients showing discrepancy between Bruch’s membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness. Correlation with the visual field (VF) was also inspected. Methods: In this prospective, cross-sectional study, 106 eyes (106 subjects) showing normal BMO-MRW classification but abnormal RNFL classification were included. All patients underwent confocal scanning laser ophthalmoscopy, spectral-domain optical coherence tomography, and standard automated perimetry. Results: Clinical characteristics were as follows: mean age: 52.79 ± 14.75 years; spherical equivalent (SE), −2.52 ± 3.48 diopter (D); SE < −5.0 D, 34 (32.1%) eyes; large disc (>2.43 mm2), 40.6%; small disc (<1.63 mm2), 12.5%; VF index, 96.72 ± 9.58%; mean deviation, −1.74 ± 3.61 dB; β-peripapillary atrophy (PPA), 96.2%; γ-PPA, 75.5%. Majority (86.1%) of these cases demonstrated normal (71.3%) or borderline (14.9%) on VF. Temporal and nasal RNFL showed significant differences among disc size subgroups (all p < 0.05). Nasal RNFL was significantly thicker in a large disc group than other subgroups. Temporal, superotemporal, inferotemporal, inferonasal RNFL, and superior RNFL peak location showed significant differences (all p < 0.05) among SE subgroups. Temporal RNFL was significantly thicker in the high myopia group than other subgroups. Conclusions: Temporalization of RNFL peaks in myopia and nasalization of RNFL peaks in large disc that display abnormal classifications might show normal classification of BMO-MRW. These findings of discrepancy between classifications should be considered in the diagnosis of early glaucoma.

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