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Editors Selection IGR 11-2

Basic Research - Sclera: Measuring lamina cribrosa pores

Comment by Claude Burgoyne on:

46385 Reproducibility of measuring lamina cribrosa pore geometry in human and nonhuman primates with in vivo adaptive optics imaging, Ivers KM; Li C; Patel N et al., Investigative Ophthalmology and Visual Science, 2011; 52: 5473-5480

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Ivers et al. (1326) report on the reproducibility of lamina cribrosa pore dimensions in two normal non-human primate and three human eyes using a confocal adaptive optics scanning laser ophthalmoscope (AOSLO). Reflectance images (840 nm) of the anterior lamina cribrosa were acquired using the AOSLO in ≥ four different sessions in two normal rhesus monkey eyes and three normal human eyes. Laminar pore areas, elongations (ratio of major to minor axes of the best-fit ellipse), and nearest neighbor distances were calculated for each session. Measurement repeatability was assessed across sessions.

Laminar pore alterations may occur and be detectable very early in glaucomatous progression

Mean variabilities in measuring pore area and elongation (i.e., mean of the standard deviation of measurements made across sessions for the same pores) were 49.7 µm² (6.1%) and 0.13 (6.7%), respectively, in monkeys, and 113 µm² (8.4%) and 0.17 (7.7%), respectively, in humans. Mean variabilities in measuring nearest neighbor distances were 1.93 µm (5.2%) in monkeys and 2.79 µm (4.1%) in humans. This work expands the scope of previous investigations into in-vivo measurement of lamina cribrosa beam and pore anatomy. It is important not only because laminar pore alterations may occur and be detectable very early in glaucomatous progression, but also because adaptive optics imaging may one day feed engineering finite element models that predict ONH susceptibility to RGC axon damage. The authors are to be congratulated for bringing their considerable skills and resources to this topic and for translating their techniques from the non-human primate to the human eye. The challenges they face include resolving laminar beams rather than pores and extending their studies to the full thickness of the lamina.

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