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Editors Selection IGR 15-4

Structure Tests and Anatomy: SD-OCT versus ONH histology

Comment by Tae-Woo Kim on:

25037 Cross-sectional anatomic configurations of peripapillary atrophy evaluated with spectral domain-optical coherence tomography, Lee KY; Tomidokoro A; Sakata R et al., Investigative Ophthalmology and Visual Science, 2010; 51: 666-671

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It has long been recognized by histologic studies that the lamina cribrosa is deformed and compressed in glaucoma. These changes in the lamina cribrosa are thought to promote optic neuropathy by decreasing support for optic nerve fibers. However, it was technically challenging to evaluate the deformation of lamina cribrosa in living patients. Strouthidis et al. (209) compared serial optic nerve head histology with interpolated B-scans generated from a 3D spectral domain (SD)-OCT optic nerve head (ONH) volume acquired in vivo from the same normal monkey eye. They found close matches between the histologic sections and interpolated B-scans throughout the extent of the ONH. Most importantly, they were able to delineate the prelaminar glial columns and the anterior surface of the lamina cribrosa. Although it is not new that SD-OCT imaging can capture the lamina cribrosa (Kagemann et al., Ophthalmic Surg Lasers Imaging, 2008;39:S126-S131, Inoue et al. Ophthalmology, 2009;116:214-222), this study validates the SD-OCT's ability to capture deep ONH structures.

SD-OCT is a powerful technique to study the deformation of the lamina cribrosa in living patients

Unfortunately, the posterior laminar surface was not detectable in this study, where images were captured using SD-OCT with a conventional 870-nm light source. For in depth evaluation of the lamina cribrosa deformation, visualization of the full thickness of the lamina is desirable. Adoption of a 1060-nm light source, which has increased axial penetration compared with the standard light source (Povazay et al., Opt Express, 2003;11:1980-1986), may be an option to improve the detection of posterior lamina. While further development is needed to better visualize the deeper portions of the lamina, this paper delivers an important message that SD-OCT is a powerful technique to study the deformation of the lamina cribrosa in living patients, which will certainly help to expand our insight into the mechanism of optic nerve damage in various types of glaucoma.

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