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Editors Selection IGR 15-2

Anatomical Structures: Lamina cribrosa

Comment by Crawford Downs on:

54048 3D modeling to characterize lamina cribrosa surface and pore geometries using in vivo images from normal and glaucomatous eyes, Sredar N; Ivers KM; Queener HM et al., Biomedical optics express, 2013; 4: 1153-1165

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Optic nerve head (ONH) biomechanics likely plays an important role in the development and progression of glaucoma, but it is not well understood. Experimental and numerical studies indicate that the ONH and lamina cribrosa undergo rapid and widespread remodeling and restructuring in response to glaucomatous insult. As a result, imaging methods that capture these changes in laminar morphology show promise as imaging target for diagnosis of glaucoma, as well as tracking progression of ONH damage in the disease. En face imaging and histologic/EM studies of laminar morphology are limited to 2D views (projections) of the tissues, which is an inherent limitation of such approaches. This is especially problematic in studies of laminar morphology, because the difference in laminar surface curvature between normal and glaucoma eyes introduces systematic bias in the results. Sredar, Porter and colleagues use adaptive optics scanning laser ophthalmoscopy (AO-SLO) to study changes in laminar pore morphology in both normal and glaucoma eyes of nonhuman primates and human patients.

3D structures like the ONH and lamina cribrosa must be described and quantified using 3D approaches that compensate for the differences in laminar curvature

In this study, they describe a method to fit a curved 3D surface to the anterior laminar surface onto which they project their 2D measurements, which corrects the error inherent to quantifying pore morphology using en face, 2D, projected views of the tissue. They report that after 3D correction, mean laminar pore area increased by 5.1% and 16.2% in normal and glaucoma eyes, respectively, as compared to measurements made with 2D projections. This result demonstrates an important principle in ONH morphology quantification, namely that complex 3D structures like the ONH and lamina cribrosa must be described and quantified using 3D approaches that compensate for the differences in laminar curvature. This study definitively shows that the 2D approaches to quantification common in the literature are inadequate to describe ONH morphology or morphologic changes, especially when comparing normal and glaucoma eyes.

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