학술논문
Differing Associations between Optic Nerve Head Strains and Visual Field Loss in Patients with Normal- and High-Tension Glaucoma.
Document Type
Academic Journal
Author
Chuangsuwanich T; Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, Republic of Singapore. Electronic address: thanadet.ch@outlook.com.; Tun TA; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore.; Braeu FA; Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.; Wang X; Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China.; Chin ZY; Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, Republic of Singapore.; Panda SK; Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Biomedical Engineering, National University of Singapore, Singapore, Republic of Singapore.; Buist M; Department of Biomedical Engineering, National University of Singapore, Singapore, Republic of Singapore.; Strouthidis N; National Institute of Health Research, Biomedical Sciences Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom.; Perera S; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.; Nongpiur M; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore.; Aung T; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore.; Girard MJA; Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore; Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland. Electronic address: mgirard@ophthalmic.engineering.com.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: To study the associations between optic nerve head (ONH) strains under intraocular pressure (IOP) elevation with retinal sensitivity in patients with glaucoma.
Design: Clinic-based cross-sectional study.
Participants: Two hundred twenty-nine patients with primary open-angle glaucoma (subdivided into 115 patients with high-tension glaucoma [HTG] and 114 patients with normal-tension glaucoma [NTG]).
Methods: For 1 eye of each patient, we imaged the ONH using spectral-domain OCT under the following conditions: (1) primary gaze and (2) primary gaze with acute IOP elevation (to approximately 35 mmHg) achieved through ophthalmodynamometry. A 3-dimensional strain-mapping algorithm was applied to quantify IOP-induced ONH tissue strain (i.e., deformation) in each ONH. Strains in the prelaminar tissue (PLT), the retina, the choroid, the sclera, and the lamina cribrosa (LC) were associated (using linear regression) with measures of retinal sensitivity from the 24-2 Humphrey visual field test (Carl Zeiss Meditec). This was performed globally, then locally according to a previously published regionalization scheme.
Main Outcome Measures: Associations between ONH strains and values of retinal sensitivity from visual field testing.
Results: For patients with HTG, we found (1) significant negative linear associations between ONH strains and retinal sensitivity (P < 0.001; on average, a 1% increase in ONH strains corresponded to a decrease in retinal sensitivity of 1.1 decibels [dB]), (2) that high-strain regions colocalized with anatomically mapped regions of high visual field loss, and (3) that the strongest negative associations were observed in the superior region and in the PLT. In contrast, for patients with NTG, no significant associations between strains and retinal sensitivity were observed except in the superotemporal region of the LC.
Conclusions: We found significant negative associations between IOP-induced ONH strains and retinal sensitivity in a relatively large glaucoma cohort. Specifically, patients with HTG who experienced higher ONH strains were more likely to exhibit lower retinal sensitivities. Interestingly, this trend in general was less pronounced in patients with NTG, which could suggest a distinct pathophysiologic relationship between the two glaucoma subtypes.
(Copyright © 2022. Published by Elsevier Inc.)
Design: Clinic-based cross-sectional study.
Participants: Two hundred twenty-nine patients with primary open-angle glaucoma (subdivided into 115 patients with high-tension glaucoma [HTG] and 114 patients with normal-tension glaucoma [NTG]).
Methods: For 1 eye of each patient, we imaged the ONH using spectral-domain OCT under the following conditions: (1) primary gaze and (2) primary gaze with acute IOP elevation (to approximately 35 mmHg) achieved through ophthalmodynamometry. A 3-dimensional strain-mapping algorithm was applied to quantify IOP-induced ONH tissue strain (i.e., deformation) in each ONH. Strains in the prelaminar tissue (PLT), the retina, the choroid, the sclera, and the lamina cribrosa (LC) were associated (using linear regression) with measures of retinal sensitivity from the 24-2 Humphrey visual field test (Carl Zeiss Meditec). This was performed globally, then locally according to a previously published regionalization scheme.
Main Outcome Measures: Associations between ONH strains and values of retinal sensitivity from visual field testing.
Results: For patients with HTG, we found (1) significant negative linear associations between ONH strains and retinal sensitivity (P < 0.001; on average, a 1% increase in ONH strains corresponded to a decrease in retinal sensitivity of 1.1 decibels [dB]), (2) that high-strain regions colocalized with anatomically mapped regions of high visual field loss, and (3) that the strongest negative associations were observed in the superior region and in the PLT. In contrast, for patients with NTG, no significant associations between strains and retinal sensitivity were observed except in the superotemporal region of the LC.
Conclusions: We found significant negative associations between IOP-induced ONH strains and retinal sensitivity in a relatively large glaucoma cohort. Specifically, patients with HTG who experienced higher ONH strains were more likely to exhibit lower retinal sensitivities. Interestingly, this trend in general was less pronounced in patients with NTG, which could suggest a distinct pathophysiologic relationship between the two glaucoma subtypes.
(Copyright © 2022. Published by Elsevier Inc.)