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Editors Selection IGR 18-4

Anatomical Structures: Lamina Cribrosa

Comment by Marcello Nicolela on:

Several previous studies have uncovered clinical, demographical and functional characteristics associated with different optic disc phenotypes seen in glaucoma (particularly focal, generalized enlargement, myopic and senile sclerotic optic disc appearances), although with some conflicting results from different groups.

In this manuscript, Sawada et al. reported data on mean and maximal lamina cribrosa (LC) depth in eyes from normal controls and from individuals with glaucoma, further sub-classified according to their optic disc phenotypes. The authors expanded on the body of knowledge related to optic disc phenotypes by showing that the LC depth differs between the groups: eyes with generalized enlargement of the cup had greater mean and maximal LC depths and eyes with senile sclerotic appearance had smallest LC depths, not different than controls. Eyes with focal and myopic appearances had intermediate LC depths.

These results suggest that the mechanisms of glaucomatous damage in these different optic disc phenotypes might vary, with the typical posterior displacement of the LC that is thought to occur in glaucoma, being absent in eyes with senile sclerotic appearance. Unfortunately, in the current study, the authors could not offer a more detailed analysis of the LC in these eyes, particularly related to LC thickness, presence and location of LC focal defects and longitudinal changes in the LC position and structure. With the advancement on OCT imaging of deeper structures within the optic nerve head, our ability to study in greater detail the LC in glaucoma might help us further understand the mechanisms associated with the development of glaucomatous optic neuropathy in these different optic disc phenotypes.

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