Seungwoo Hong1, Hongli Yang2, Stuart K Gardiner3, Haomin Luo4, Christy Hardin2, Glen P Sharpe5, Joseph Caprioli6, Shaban Demirel3, Christopher A Girkin7, Jeffrey M Liebmann8, Christian Y Mardin9, Harry A Quigley10, Alexander F Scheuerle11, Brad Fortune3, Balwantray C Chauhan5, Claude F Burgoyne12. 1. Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Department of Ophthalmology, Medical College, the Catholic University of Korea, Seoul, Korea. 2. Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA. 3. Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA. 4. Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, P.R. China; Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA. 5. Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada. 6. Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. 7. Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 8. Einhorn Clinical Research Center, Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of Mount Sinai Health System, New York, USA. 9. Department of Ophthalmology, University of Erlangen, Erlangen, Germany. 10. Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA. 11. Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. 12. Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA. Electronic address: cfburgoyne@deverseye.org.
Abstract
PURPOSE: To assess anterior scleral canal opening (ASCO) offset relative to Bruch's membrane opening (BMO) (ASCO/BMO offset) so as to determine neural canal direction, obliqueness, and minimum cross-sectional area (NCMCA) in 362 healthy eyes. DESIGN: Cross-sectional study. METHODS: After optical coherence tomography optic nerve head and retinal nerve fiber layer thickness (RNFLT) imaging, BMO and ASCO were manually segmented. Planes, centroids, size, and shape were calculated. Neural canal direction was defined by projecting the neural canal axis vector (connecting BMO and ASCO centroids) onto the BMO plane. Neural canal obliqueness was defined by the angle between the neural canal axis and the BMO plane perpendicular vector. NCMCA was defined by projecting BMO and ASCO points onto a neural canal axis perpendicular plane and measuring the area of overlap. The angular distance between superior and inferior peak RNFLT was measured, and correlations between RFNLT, BMO, ASCO, ASCO/BMO offset, and NCMCA were assessed. RESULTS: Mean (SD) NCMCA was significantly smaller than either the BMO or ASCO area (1.33 (0.42), 1.82 (0.38), 2.22 (0.43) mm2, respectively), and most closely correlated to RNFLT (P < .001, R2 = 0.158). Neural canal direction was most commonly superior-nasal (55%). Mean neural canal obliqueness was 39.4° (17.3°). The angular distance between superior and inferior peak RNFLT correlated to neural canal direction (P ≤ .008, R2 = 0.093). CONCLUSIONS: ASCO/BMO offset underlies neural canal direction, obliqueness, and NCMCA. RNFLT is more strongly correlated to NCMCA than to BMO or ASCO, and its peripapillary distribution is influenced by neural canal direction.
PURPOSE: To assess anterior scleral canal opening (ASCO) offset relative to Bruch's membrane opening (BMO) (ASCO/BMO offset) so as to determine neural canal direction, obliqueness, and minimum cross-sectional area (NCMCA) in 362 healthy eyes. DESIGN: Cross-sectional study. METHODS: After optical coherence tomography optic nerve head and retinal nerve fiber layer thickness (RNFLT) imaging, BMO and ASCO were manually segmented. Planes, centroids, size, and shape were calculated. Neural canal direction was defined by projecting the neural canal axis vector (connecting BMO and ASCO centroids) onto the BMO plane. Neural canal obliqueness was defined by the angle between the neural canal axis and the BMO plane perpendicular vector. NCMCA was defined by projecting BMO and ASCO points onto a neural canal axis perpendicular plane and measuring the area of overlap. The angular distance between superior and inferior peak RNFLT was measured, and correlations between RFNLT, BMO, ASCO, ASCO/BMO offset, and NCMCA were assessed. RESULTS: Mean (SD) NCMCA was significantly smaller than either the BMO or ASCO area (1.33 (0.42), 1.82 (0.38), 2.22 (0.43) mm2, respectively), and most closely correlated to RNFLT (P < .001, R2 = 0.158). Neural canal direction was most commonly superior-nasal (55%). Mean neural canal obliqueness was 39.4° (17.3°). The angular distance between superior and inferior peak RNFLT correlated to neural canal direction (P ≤ .008, R2 = 0.093). CONCLUSIONS:ASCO/BMO offset underlies neural canal direction, obliqueness, and NCMCA. RNFLT is more strongly correlated to NCMCA than to BMO or ASCO, and its peripapillary distribution is influenced by neural canal direction.
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