Lamina Cribrosa and Peripapillary Sclera Histomorphometry in Normal and Advanced Glaucomatous Chinese Eyes with Various Axial Length

PURPOSE. To measure laminar and peripapillary scleral architecture in normal and glaucomatous Chinese eyes with normal and those with elongated axial length. METHODS. The histomorphometric investigation included a normal group (nonaxially elongated eyes) of 40 human globes (40 patients; mean age, 41.3 +/- 13.4 years; range, 15-68) enucleated because of malignant choroidal melanoma, a glaucomatous group (non-axially elongated eyes) of 55 eyes (55 patients; age, 43.3 +/- 20.3 years; range, 12-88) enucleated because of painful secondary angle-closure glaucoma, and a group of 26 glaucomatous globes (glaucomatous elongated axial length group; 26 patients; age, 29.0 +/- 14.4 years; range, 12-60) with an axial length > 27.5 mm. Anterior-posterior histologic sections were morphometrically evaluated. RESULTS. The lamina cribrosa was significantly (P < 0.001) thicker in the normal group than in the glaucomatous group, in which it was significantly (P < 0.001) thicker than in the glaucomatous elongated-length group. Lamina cribrosa thickness decreased significantly with increasing axial length (P < 0.001) and presence of glaucoma (P < 0.001). Peripapillary scleral thickness close to the optic nerve scleral canal and just outside of the optic nerve meninges decreased significantly with increasing axial length (P = 0.04 and P = 0.02, respectively). Peripapillary scleral thickness did not vary significantly between the glaucomatous group and the normal group. The distance between the intraocular space and cerebrospinal fluid space was (P < 0.001) shorter in the two glaucomatous groups than in the normal group. CONCLUSIONS. Lamina cribrosa thickness and peripapillary sclera thickness decreased significantly with axial length, in addition to a glaucoma-related thinning of the lamina cribrosa. In non axially elongated eyes, the peripapillary sclera thickness did not vary significantly between glaucomatous eyes and normal eyes. (Invest Ophthalmol Vis Sci. 2009;50:2175-2184) DOI:10.1167/iovs.07-1429