The Characteristics of Lamina Cribrosa Defects in Myopic Eyes With and Without Open-Angle Glaucoma.

PURPOSE: We investigated the lamina cribrosa (LC) structural characteristics of myopic eyes with and without open-angle glaucoma (OAG) using enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT).

METHODS: Defects in the LC in myopic eyes with and without OAG and normal eyes without myopia were evaluated using EDI SD-OCT. Among the two types of LC defects, disinsertion type and hole type, the associations among disinsertion type LC defects, myopia-related parameters of axial length (AL), maximal γ-zone peripapillary atrophy (PPA) length, disc tilt angle, and the presence of glaucoma were evaluated. In addition, disinsertion type LC defects were divided into two subtypes, complete detachment type and triangular wedge type, and the numbers of the subtypes in myopic eyes with and without OAG were investigated.

RESULTS: Defects in the LC were found more in myopic eyes with than without OAG (65.7% vs. 27.8%, P < 0.001). Of LC defects, disinsertion-type LC defects were found at the location of the γ-zone PPA (R = 0.71, P < 0.001), while the location of hole-type LC defects did not correlate with the location of the γ-zone PPA (R = 0.07, P = 0.73). Of disinsertion-type LC defects, complete detachment-type defects predominated in myopic eyes with OAG, while triangular wedge-type defects were the most common in myopic eyes without OAG (P < 0.001; P < 0.001, respectively). In multivariate logistic regression analysis, disinsertion-type LC defects in myopic eyes were associated with AL, maximal PPA length, and disc tilt angle, as well as the presence of glaucoma.

CONCLUSIONS: Given the strong correlation of disinsertion type LC defects with glaucoma and parameters related to myopia, such defects should be considered as biomarkers of glaucoma in myopic eyes.