Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Evaluation of Optic Nerve Head Biomechanical Properties in Pseudoexfoliation Glaucoma with Real-time Elastography

Author(s): Ozlem Unal*, Mehtap Caglayan, Pinar Kosekahya, Fatma Yulek and Guzin Taslipinar

Volume 15, Issue 7, 2019

Page: [637 - 644] Pages: 8

DOI: 10.2174/1573405614666180621093908

Price: $65

Abstract

Purpose: To investigate the biomechanical properties of the optic nerve head in patients with Pseudoexfoliation (PEX) glaucoma using Real-time Elastography (RTE) and to compare these results with those of Primary Open Angle Glaucoma (POAG) patients and healthy subjects.

Methods: Twenty eyes of 20 PEX glaucoma patients (PEX group), 20 eyes of 20 POAG patients (POAG group), and 20 eyes of 20 healthy subjects (control group) were enrolled in this prospective study. The strain Ratios of Orbital Fat to Optic Nerve head (ROFON) and lateral rectus muscle to optic nerve head (RLRON) were determined. Comparisons were performed using Chi-square, Kruskal Wallis, Mann-Whitney U, and One-way ANOVA tests.

Results: The strain ratios of orbital fat to optic nerve head were 2.34, 6.85 and 1.76 in PEX glaucoma, POAG, and control groups, respectively (p<0.001). The strain ratios of the lateral rectus muscle to the optic nerve head were 0.51, 0.82, and 0.55 in PEX glaucoma, POAG, and control groups, respectively (p=0.256).

Conclusion: The strain ratios of orbital fat to optic nerve head were different in PEX glaucoma patients than in POAG and control groups. RTE can provide biomechanical assessment of the optic nerve head in a non-invasive, quick, easily accessible, and user-friendly manner.

Keywords: Pseudoexfoliation glaucoma, optic nerve head biomechanics, real time elastography, optic neuropathy, intraocular pressure, patients.

Graphical Abstract

[1]
Yüksel N, Karabaş VL, Arslan A, Demirci A, Cağlar Y. Ocular hemodynamics in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Ophthalmology 2001; 108(6): 1043-9.
[http://dx.doi.org/10.1016/S0161-6420(01)00572-3] [PMID: 11382627]
[2]
Harju M, Vesti E. Blood flow of the optic nerve head and peripapillary retina in exfoliation syndrome with unilateral glaucoma or ocular hypertension. Graefes Arch Clin Exp Ophthalmol 2001; 239(4): 271-7.
[http://dx.doi.org/10.1007/s004170100269] [PMID: 11450491]
[3]
Ocakoğlu O, Koyluoğlu N, Kayiran A, Tamcelik N, Ozkan S. Microvascular blood flow of the optic nerve head and peripapillary retina in unilateral exfoliation syndrome. Acta Ophthalmol Scand 2004; 82(1): 49-53.
[http://dx.doi.org/10.1046/j.1600-0420.2003.00196.x] [PMID: 14982047]
[4]
Netland PA, Ye H, Streeten BW, Hernandez MR. Elastosis of the lamina cribrosa in pseudoexfoliation syndrome with glaucoma. Ophthalmology 1995; 102(6): 878-86.
[http://dx.doi.org/10.1016/S0161-6420(95)30939-6] [PMID: 7777294]
[5]
Levy NS, Crapps EE. Displacement of optic nerve head in response to short-term intraocular pressure elevation in human eyes. Arch Ophthalmol 1984; 102(5): 782-6.
[http://dx.doi.org/10.1001/archopht.1984.01040030630037] [PMID: 6721773]
[6]
Phillips JR, McBrien NA. Form deprivation myopia: elastic properties of sclera. Ophthalmic Physiol Opt 1995; 15(5): 357-62.
[http://dx.doi.org/10.1016/0275-5408(95)00062-I] [PMID: 8524554]
[7]
Sigal IA, Flanagan JG, Tertinegg I, Ethier CR. Finite element modeling of optic nerve head biomechanics. Invest Ophthalmol Vis Sci 2004; 45(12): 4378-87.
[http://dx.doi.org/10.1167/iovs.04-0133] [PMID: 15557446]
[8]
Eilaghi A, Flanagan JG, Simmons CA, Ethier CR. Effects of scleral stiffness properties on optic nerve head biomechanics. Ann Biomed Eng 2010; 38(4): 1586-92.
[http://dx.doi.org/10.1007/s10439-009-9879-7] [PMID: 20039133]
[9]
Onur MR, Poyraz AK, Ucak EE, Bozgeyik Z, Özercan IH, Ogur E. Semiquantitative strain elastography of liver masses. J Ultrasound Med 2012; 31(7): 1061-7.
[http://dx.doi.org/10.7863/jum.2012.31.7.1061] [PMID: 22733855]
[10]
Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology 2006; 239(2): 341-50.
[http://dx.doi.org/10.1148/radiol.2391041676] [PMID: 16484352]
[11]
Thomas A, Fischer T, Frey H, et al. Real-time elastography--an advanced method of ultrasound: First results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006; 28(3): 335-40.
[http://dx.doi.org/10.1002/uog.2823] [PMID: 16909438]
[12]
Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology 2005; 237(1): 202-11.
[http://dx.doi.org/10.1148/radiol.2363041248] [PMID: 16118150]
[13]
Taylor LS, Rubens DJ, Porter BC, et al. Prostate cancer: three-dimensional sonoelastography for in vitro detection. Radiology 2005; 237(3): 981-5.
[http://dx.doi.org/10.1148/radiol.2373041573] [PMID: 16251396]
[14]
Thomas A, Kümmel S, Gemeinhardt O, Fischer T. Real-time sonoelastography of the cervix: tissue elasticity of the normal and abnormal cervix. Acad Radiol 2007; 14(2): 193-200.
[http://dx.doi.org/10.1016/j.acra.2006.11.010] [PMID: 17236992]
[15]
Friedrich-Rust M, Ong MF, Herrmann E, et al. Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis. AJR Am J Roentgenol 2007; 188(3): 758-64.
[http://dx.doi.org/10.2214/AJR.06.0322] [PMID: 17312065]
[16]
Detorakis ET, Drakonaki EE, Tsilimbaris MK, Pallikaris IG, Giarmenitis S. Real-time ultrasound elastographic imaging of ocular and periocular tissues: a feasibility study. Ophthalmic Surg Lasers Imaging 2010; 41(1): 135-41.
[http://dx.doi.org/10.3928/15428877-20091230-24] [PMID: 20128584]
[17]
Pekel G, Ağladıoğlu K, Acer S, Yağcı R, Kaşıkçı A. Evaluation of Ocular and Periocular Elasticity after Panretinal Photocoagulation: An Ultrasonic Elastography Study. Curr Eye Res 2014; 15(3): 1-6.
[PMID: 24833498]
[18]
Touboul D, Gennisson JL, Nguyen TM, et al. Supersonic shear wave elastography for the in vivo evaluation of transepithelial corneal collagen cross-linking. Invest Ophthalmol Vis Sci 2014; 55(3): 1976-84.
[http://dx.doi.org/10.1167/iovs.13-13445] [PMID: 24519426]
[19]
Nakashima K, Shiina T, Sakurai M, et al. JSUM ultrasound elastography practice guidelines: breast. J Med Ultrason (2001) 2013; 40(4): 359-91.
[http://dx.doi.org/10.1007/s10396-013-0457-0]] [PMID: 27277451]
[20]
Ritch R, Schlötzer-Schrehardt U. Exfoliation syndrome. Surv Ophthalmol 2001; 45(4): 265-315.
[http://dx.doi.org/10.1016/S0039-6257(00)00196-X] [PMID: 11166342]
[21]
Linnér E, Schwartz B, Araujo D. Optic disc pallor and visual field defect in exfoliative and non-exfoliative, untreated ocular hypertension. Int Ophthalmol 1989; 13(1-2): 21-4.
[http://dx.doi.org/10.1007/BF02028632] [PMID: 2744950]
[22]
Davanger M, Ringvold A, Blika S. Pseudo-exfoliation, IOP and glaucoma. Acta Ophthalmol (Copenh) 1991; 69(5): 569-73.
[http://dx.doi.org/10.1111/j.1755-3768.1991.tb04841.x] [PMID: 1776408]
[23]
Puska P, Vesti E, Tomita G, Ishida K, Raitta C. Optic disc changes in normotensive persons with unilateral exfoliation syndrome: a 3-year follow-up study. Graefes Arch Clin Exp Ophthalmol 1999; 237(6): 457-62.
[http://dx.doi.org/10.1007/s004170050261] [PMID: 10379604]
[24]
Yarangümeli A, Davutluoglu B, Köz OG, Elhan AH, Yaylaci M, Kural G. Glaucomatous damage in normotensive fellow eyes of patients with unilateral hypertensive pseudoexfoliation glaucoma: normotensive pseudoexfoliation glaucoma? Clin Exp Ophthalmol 34(1): 15-9.
[http://dx.doi.org/10.1111/j.1442-9071.2006.01140.x] [PMID: 16451253]
[25]
European Glaucoma Society Classification and terminology. Terminology and Guidelines for Glaucoma Traverso CE, Ed. Savona: Editrice Dogma. 2003; 26-30.
[26]
Hodapp E, Parrish RK II, Anderson DR. Clinical Decisions in Glaucoma. St Louis: Mosby 1993; pp. 52-61.
[27]
Streeten BW, Dark AJ, Wallace RN, Li ZY, Hoepner JA. Pseudoexfoliative fibrillopathy in the skin of patients with ocular pseudoexfoliation. Am J Ophthalmol 1990; 110(5): 490-9.
[http://dx.doi.org/10.1016/S0002-9394(14)77871-7] [PMID: 2240134]
[28]
Streeten BW, Li ZY, Wallace RN, Eagle RC Jr, Keshgegian AA. Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome. Arch Ophthalmol 1992; 110(12): 1757-62.
[http://dx.doi.org/10.1001/archopht.1992.01080240097039] [PMID: 1463419]
[29]
Schlötzer-Schrehardt UM, Koca MR, Naumann GO, Volkholz H. Pseudoexfoliation syndrome. Ocular manifestation of a systemic disorder? Arch Ophthalmol 1992; 110(12): 1752-6.
[http://dx.doi.org/10.1001/archopht.1992.01080240092038] [PMID: 1463418]
[30]
Netland PA, Ye H, Streeten BW, Hernandez MR. Elastosis of the lamina cribrosa in pseudoexfoliation syndrome with glaucoma. Ophthalmology 1995; 102(6): 878-86.
[http://dx.doi.org/10.1016/S0161-6420(95)30939-6] [PMID: 7777294]
[31]
Pena JD, Netland PA, Vidal I, Dorr DA, Rasky A, Hernandez MR. Elastosis of the lamina cribrosa in glaucomatous optic neuropathy. Exp Eye Res 1998; 67(5): 517-24.
[http://dx.doi.org/10.1006/exer.1998.0539] [PMID: 9878213]
[32]
Nguyen C, Cone FE, Nguyen TD, et al. Studies of scleral biomechanical behavior related to susceptibility for retinal ganglion cell loss in experimental mouse glaucoma. Invest Ophthalmol Vis Sci 2013; 54(3): 1767-80.
[http://dx.doi.org/10.1167/iovs.12-10952] [PMID: 23404116]
[33]
Burgoyne CF, Downs JC, Bellezza AJ, Hart RT. Three-dimensional reconstruction of normal and early glaucoma monkey optic nerve head connective tissues. Invest Ophthalmol Vis Sci 2004; 45(12): 4388-99.
[http://dx.doi.org/10.1167/iovs.04-0022] [PMID: 15557447]
[34]
Zeimer RC, Ogura Y. The relation between glaucomatous damage and optic nerve head mechanical compliance. Arch Ophthalmol 1989; 107(8): 1232-4.
[http://dx.doi.org/10.1001/archopht.1989.01070020298042] [PMID: 2527025]
[35]
Quigley HA, Hohman RM, Addicks EM, Massof RW, Green WR. Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma. Am J Ophthalmol 1983; 95(5): 673-91.
[http://dx.doi.org/10.1016/0002-9394(83)90389-6] [PMID: 6846459]
[36]
Albon J, Karwatowski WSS, Avery N, Easty DL, Duance VC. Changes in the collagenous matrix of the aging human lamina cribrosa. Br J Ophthalmol 1995; 79(4): 368-75.
[http://dx.doi.org/10.1136/bjo.79.4.368] [PMID: 7742286]
[37]
Hernandez MR, Luo XX, Andrzejewska W, Neufeld AH. Age-related changes in the extracellular matrix of the human optic nerve head. Am J Ophthalmol 1989; 107(5): 476-84.
[http://dx.doi.org/10.1016/0002-9394(89)90491-1] [PMID: 2653045]
[38]
Morrison JC, Jerdan JA, Dorman ME, Quigley HA. Structural proteins of the neonatal and adult lamina cribrosa. Arch Ophthalmol 1989; 107(8): 1220-4.
[http://dx.doi.org/10.1001/archopht.1989.01070020286040] [PMID: 2757553]
[39]
Garway-Heath DF, Wollstein G, Hitchings RA. Aging changes of the optic nerve head in relation to open angle glaucoma. Br J Ophthalmol 1997; 81(10): 840-5.
[http://dx.doi.org/10.1136/bjo.81.10.840] [PMID: 9486023]
[40]
Hoyt WF, Frisén L, Newman NM. Fundoscopy of nerve fiber layer defects in glaucoma. Invest Ophthalmol 1973; 12(11): 814-29.
[PMID: 4752920]
[41]
Airaksinen PJ, Drance SM, Douglas GR, Mawson DK, Nieminen H. Diffuse and localized nerve fiber loss in glaucoma. Am J Ophthalmol 1984; 98(5): 566-71.
[http://dx.doi.org/10.1016/0002-9394(84)90242-3] [PMID: 6496612]
[42]
Quigley HA, Miller NR, George T. Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage. Arch Ophthalmol 1980; 98(9): 1564-71.
[http://dx.doi.org/10.1001/archopht.1980.01020040416003] [PMID: 7425916]
[43]
Sommer A, Miller NR, Pollack I, Maumenee AE, George T. The nerve fiber layer in the diagnosis of glaucoma. Arch Ophthalmol 1977; 95(12): 2149-56.
[http://dx.doi.org/10.1001/archopht.1977.04450120055003] [PMID: 588106]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy