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Editors Selection IGR 24-3

Anatomical Structures: Lamina Cribrosa

Comment by Linda Zangwill & Min Hee Suh on:

Focal LC defect is known to be an important biomarker in the development and progression of the glaucomatous optic neuropathy. Recent studies reported that structural changes of the optic nerve head (ONH) such as neuroretinal rim loss and retinal nerve fiber layer defect were related with the focal LC defect. However, little is known about the correlation between the myopic morphologic changes of the ONH and the LC defect. Miki et al. assessed the prevalence and characteristics of the focal LC defects in four subgroups; high myopic eyes with (67 eyes) and without open-angle glaucoma (OAG) (35 eyes), non-myopic eyes with OAG (22 eyes), and healthy normal non-myopic eyes (35 eyes). This study is in line with previous studies that LC defects were commonly found in glaucomatous eyes. Moreover, prevalence of LC defect was significantly higher in myopic eyes without OAG (8/35, 22.9 %) than non-myopic healthy eyes (1/35, 0.03 %) (P = 0.0304). These findings suggest that alternation of the biomechanical environments induced by myopia may be related with the development of focal LC damage. However, it is still unclear whether focal LC defect associated with myopia would be pathologically related to the glaucomatous damage. In this study, myopia-related morphologic factors such as axial length, β-zone parapapillary atrophy, ovality index, or disc area were not significantly different between eyes with and without LC defects. This study is also limited by the cross-sectional nature of the study design and small sample size. Further longitudinal studies are warranted to elucidate whether LC defects detected in the high myopic eyes would play a causative role in the development and progression of the glaucomatous optic neuropathy.

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