Volume 82, Issue 9 (December 2024)
Tehran Univ Med J 2024, 82(9): 670-676 |
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Yazdan Panah D, Arish M. Investigating and comparing the thickness of prelamina and lamina cribrosa tissue of the optic nerve before and after treatment in patients with closed-angle and open-angle glaucoma. Tehran Univ Med J 2024; 82 (9) :670-676
URL: http://tumj.tums.ac.ir/article-1-13342-en.html
URL: http://tumj.tums.ac.ir/article-1-13342-en.html
1- Department of Ophthalmology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
2- Department of Ophthalmology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. ,arish.mohammed@gmail.com
2- Department of Ophthalmology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. ,
Abstract: (1094 Views)
Background: The thickness of the lamina, especially the lamina cribrosa and prelamina, can be important indicators of optic nerve damage and the severity of glaucoma. Changes in the thickness of these tissues after treatment can indicate improvement or reduction in intraocular pressure (ICP) and nerve protection. ICP produces a different response in the treatment of patients with closed-angle glaucoma (CAG) and open-angle glaucoma (OAG). The aim of this study was to compare the thickness of prelamina and lamina cribrosa tissue before and after treatment in CAG and OAG patients.
Methods: The present study is a descriptive-analytical study conducted on 56 glaucoma patients referred to an Al Zahra Eye Hospital (Zahedan) who had undergone trabeculectomy or laser iridotomy treatment from April to March 2022. Patients were divided into two equal groups, including CAG patients (n=28) and OAG patients (n=28), and at the beginning of the study, in terms of demographic variables, visual acuity, ratio of cup diameter to disc size (C/D), anterior segment depth (ACD), central corneal thickness (CCT), intraocular pressure (IOP) and prelamina and lamina cribrosa tissue thickness were investigated. the thickness of the lamina cribrosa tissue was measured as the distance between the anterior and posterior borders of the highly reflective area in the EDI-OCT horizontal section at the optic nerve head. The measurement of the thickness of the lamina cribrosa tissue was also measured to the extent of safety in the center where there were less vessels. Then CAG patients underwent laser iridotomy and OAG patients underwent trabeculectomy surgery. Before the treatment and after 1 month, 3 months and 6 months after the treatment, the patients underwent FU with the help of ONH OCT and the thickness of the prelamina and lamina cribrosa tissue was checked.
Methods: The present study is a descriptive-analytical study conducted on 56 glaucoma patients referred to an Al Zahra Eye Hospital (Zahedan) who had undergone trabeculectomy or laser iridotomy treatment from April to March 2022. Patients were divided into two equal groups, including CAG patients (n=28) and OAG patients (n=28), and at the beginning of the study, in terms of demographic variables, visual acuity, ratio of cup diameter to disc size (C/D), anterior segment depth (ACD), central corneal thickness (CCT), intraocular pressure (IOP) and prelamina and lamina cribrosa tissue thickness were investigated. the thickness of the lamina cribrosa tissue was measured as the distance between the anterior and posterior borders of the highly reflective area in the EDI-OCT horizontal section at the optic nerve head. The measurement of the thickness of the lamina cribrosa tissue was also measured to the extent of safety in the center where there were less vessels. Then CAG patients underwent laser iridotomy and OAG patients underwent trabeculectomy surgery. Before the treatment and after 1 month, 3 months and 6 months after the treatment, the patients underwent FU with the help of ONH OCT and the thickness of the prelamina and lamina cribrosa tissue was checked.
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Results: After 6 months, the thickness of the lamina cribrosa in patients with CAG increased from 160.21 ± 30.21 µm to 201.73 ± 40.07 µm, and in the OAG group, it increased from 173.71 ± 39 µm to 182.86 ± 46.39 µm. The thickness of the prelamina tissue in patients with CAG increased from 155.46 ± 42.14 µm to 170.03 ± 35.31 µm, and in the OAG group, it increased from 172.57 ± 41.91 µm to 180.07 ± 32.06 µm (P<0.05 for all). Before treatment, the thickness of the prelamina tissue and the lamina cribrosa in patients with CAG was significantly less than in patients with OAG (P<0.05). After 6 months, the lamina cribrosa thickness in patients with CAG (201.73 ± 40.07 µm) was significantly greater than in patients with OAG (182.86 ± 46.39 µm) (P= 0.023).
Conclusion: The increase in the thickness of prelamina tissue and lamina cribrosa tissue after surgery in CAG and OAG patients using OCT imaging is different and the amount of increase in the thickness of lamina cribrosa tissue is more in CAG patients. |
Type of Study: Original Article |
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