Curr Opin Ophthalmol 2017[Mar]; 28 (2): 113-9 PMID27898470show ga
Purpose of Review: To present, summarize and interpret most recent advances in the study and understanding of the lamina cribrosa (LC) in glaucoma, in the context of previous work. Recent Findings: The lamina is an active living structure that responds to strain and changes morphology at the micro- and macro-scales in glaucoma. Changes in LC morphology in glaucoma include posteriorization of the laminar insertion into the sclera, increased cupping or depth of the LC, and the development of focal LC defects. These LC changes are associated with disk hemorrhages and visual field damage, and are detectable with clinical imaging techniques such as optical coherence tomography (OCT). Glaucomatous changes in the LC are driven by cellular processes mediated by focal cyclical mechanical strain. Strain is eye specific and mediated by IOP, cerebrospinal fluid pressure (CSFP), and scleral and LC morphology and structural stiffness; deleterious LC strains can occur at all levels of mean IOP. Summary: Laminar morphology is ever changing in health and disease, and recent studies have identified several promising morphological changes that are indicative of glaucoma susceptibility, onset and progression.
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Curr+Opin+Ophthalmol 2017 ; 28 (2): 113-9
