Deep optic nerve head morphology and glaucoma progression in eyes with and without laminar dot sign: a longitudinal comparative study

Purpose To investigate the association between the laminar dot sign (LDS) and the deep optic nerve head (ONH) structure in eyes with primary-open-angle glaucoma (POAG). Methods Eighty-four eyes of 84 patients with POAG were prospectively included. All of the patients underwent stereo optic disc photography (SDP), red-free retinal nerve fibre layer (RNFL) photography, SS-OCT, and standard automated perimetry. By evaluating the SDP, patients were classified into laminar dot sign (LDS) and non-LDS groups. The deep structure of the ONH including the anterior prelaminar depth (APLD) and prelaminar tissue thickness (PTT) were quantitated using SS-OCT. Progression was assessed by structural or functional deterioration during the average 4.3 +/- 1.2 years of follow-up. Results The LDS group had deeper APLD (405.47 +/- 107.55 vs. 302.45 +/- 149.51, P < 0.001) and thinner PTT (74.34 +/- 24.46 vs. 137.29 +/- 40.07, P = 0.001) relative to the non-LDS group. By multivariate analysis, thin PTT was significantly associated with the presence of LDS (odds ratio = 0.939, P < 0.001). Structural progression was detected in 45 eyes (84.9%) in the LDS group and 8 eyes (25.8%) in the non-LDS group. Functional progression was demonstrated in 29 eyes (34.5%) in the LDS group and 6 eyes (19.4%) in the non-LDS group. The eyes with LDS had a significantly higher risk of glaucoma progression (chi(2) = 5.00, degree of freedom = 1, P = 0.033). Conclusions In eyes with POAG, the presence of LDS was associated with thinner prelaminar tissue and faster disease progression.

Automated summary

In eyes with POAG, the presence of the laminar dot sign (LDS) is associated with thinner prelaminar tissue and faster disease progression. Eyes with LDS have a significantly higher risk of glaucoma progression compared to those without LDS.