Diagnostic Power of Lamina Cribrosa Depth and Curvature in Glaucoma

PURPOSE. To compare the capability of the lamina cribrosa depth (LCD) and lamina cribrosa (LC) curvature in discriminating between eyes with primary open-angle glaucoma (POAG) and healthy eyes. METHODS. Seventy-seven eyes of 77 patients with POAG and 77 eyes of 77 healthy subjects who were matched for age, sex, and axial length were included. The LCD and lamina cribrosa curvature index (LCCI) were measured in B-scan images obtained using swept-source optical coherence tomography at seven locations spaced equidistantly across the vertical optic disc diameter. The mean values of the measurements made at seven points of the LC were defined as the average LCD and LCCI. RESULTS. The average LCD (527.0 6 116.4 vs. 413.3 6 80.4 lm, P < 0.001) and average LCCI (10.97 6 2.59 vs. 6.81 6 1.43, P < 0.001) were significantly larger in POAG eyes than in the matched healthy subjects (all seven locations, P < 0.001). The area under the receiver operating characteristic curve (AUC) was significantly larger for the LCCI than the LCD (0.921 vs. 0.784, P < 0.001). The intraocular pressure was positively associated with average LCD and LCCI in healthy subjects (P = 0.021 and P < 0.001, respectively) and POAG patients (P = 0.011 and P < 0.001, respectively). Male sex was associated with larger average LCCI (P = 0.013) and LCD (P = 0.008) in POAG. CONCLUSIONS. The LCCI had significantly better discriminating capability between POAG and healthy eyes than LCD. This finding suggests that the LCCI may serve better than the LCD for improved glaucoma management.