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Graefes Arch Clin Exp OphthalmolOctober 20242 citations

The association between asymmetric stress distribution on the lamina cribrosa and glaucoma progression.

Kang Edward, Park Ji-Hye, Yoo Chungkwon, Kim Yong Yeon


AI Summary

This study found glaucoma progressors exhibit higher asymmetric stress on the lamina cribrosa during eye movement, a factor potentially contributing to progression and linked to optic disc geometry.

Abstract

Purpose

The purpose of this study was to assess the effect of ocular movements on the progression of glaucoma.

Methods

A total of 118 primary open-angle glaucoma patients were enrolled, comprising 71 patients in the progression group and 47 patients in the non-progression group. Utilizing three geometric parameters-axial length, optic disc radius, and optic cup deepening-a personalized virtual optic nerve head (ONH) model was designed. ONH biomechanical changes during ocular movement were simulated using a finite element analysis. Simulation results were analyzed and compared between the progression and non-progression groups.

Results

In both progression and non-progression groups, ONH strains significantly increased with increasing rotation angle. When the eye rotated by 10°, the stress on the anterior surface of the lamina cribrosa on the temporal side was significantly higher in the progression group compared to the non-progression group (16.19 ± 0.90 kPa vs. 13.24 ± 3.00 kPa, P < 0.001). The stress ratio, indicating asymmetric stress distribution, was higher in the progression group than in the non-progression group (0.56 ± 0.13 vs. 0.49 ± 0.19, P = 0.018). Stress ratio significantly increased with increasing optic disc radius (standardized β = 0.303, P < 0.001) and optic cup deepening (standardized β = 0.538, P < 0.001).

Conclusions

Asymmetric stress distribution with ocular movement was higher in the progression group. This asymmetry was associated with optic disc radius and optic cup deepening. Therefore, ocular movement may contribute to the progression of glaucoma, with ONH geometry playing a role.

Key messages: WHAT IS KNOWN : Ocular movement is considered one of the physical stress factors affecting the optic nerve head.

What is new: Ocular movement increased the strain on the optic nerve head and resulted in an asymmetric stress distribution on the lamina cribrosa surface. Asymmetric stress distribution on lamina cribrosa with ocular movement was higher in the glaucoma progression group and associated with optic disc radius and optic cup deepening.


MeSH Terms

HumansOptic DiskDisease ProgressionMaleGlaucoma, Open-AngleFemaleIntraocular PressureMiddle AgedVisual FieldsTomography, Optical CoherenceEye MovementsFinite Element AnalysisAgedStress, MechanicalBiomechanical Phenomena

Key Concepts5

In a study of 118 primary open-angle glaucoma patients (71 in the progression group and 47 in the non-progression group), when the eye rotated by 10°, the stress on the anterior surface of the lamina cribrosa on the temporal side was significantly higher in the progression group compared to the non-progression group (16.19  0.90 kPa vs. 13.24  3.00 kPa, P < 0.001).

PrognosisCohortCohort Studyn=118 primary open-angle glaucoma patientsCh5Ch12

In a study of 118 primary open-angle glaucoma patients (71 in the progression group and 47 in the non-progression group), the stress ratio, indicating asymmetric stress distribution on the lamina cribrosa, was higher in the glaucoma progression group than in the non-progression group (0.56  0.13 vs. 0.49  0.19, P = 0.018).

PrognosisCohortCohort Studyn=118 primary open-angle glaucoma patientsCh5Ch12

In a study of 118 primary open-angle glaucoma patients, the stress ratio on the lamina cribrosa significantly increased with increasing optic disc radius (standardized  = 0.303, P < 0.001) and optic cup deepening (standardized  = 0.538, P < 0.001).

MechanismCohortCohort Studyn=118 primary open-angle glaucoma patientsCh5Ch12

Ocular movement increased the strain on the optic nerve head and resulted in an asymmetric stress distribution on the lamina cribrosa surface in both glaucoma progression and non-progression groups.

MechanismCohortCohort Studyn=118 primary open-angle glaucoma patientsCh5

A personalized virtual optic nerve head (ONH) model was designed for 118 primary open-angle glaucoma patients utilizing three geometric parameters: axial length, optic disc radius, and optic cup deepening, and ONH biomechanical changes during ocular movement were simulated using a finite element analysis.

MethodologyBasic ScienceSimulation Studyn=118 primary open-angle glaucoma patientsCh5

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