Effects of Orbital Decompression on Lamina Cribrosa Depth in Patients with Graves’ Orbitopathy
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Purpose: We sought to investigate the effects of Graves’ orbitopathy (GO) and orbital decompression on laminacribrosa depth (LCD) using spectral-domain optical coherence tomography. Methods: Forty eyes that underwent orbital decompression to relieve compressive optic neuropathy or correctdisfiguring exophthalmos in the context of GO were included. Subjects were imaged with spectral-domain opticalcoherence tomography before surgery and at 1 and 3 months after surgery, at which the examiner measuredthe LCD (distance from the anterior surface of the lamina cribrosa to the Bruch membrane opening line)and peripapillary retinal nerve fiber layer thickness. Subjects were divided into two groups—a muscle-dominantgroup composed of patients who had extraocular muscle enlargement on preoperative orbital computedtomography scan and a fat-dominant group composed of patients who did not show extraocular muscle enlargementon preoperative orbital computed tomography scan—and subgroup analysis was performed. Preoperativeand postoperative intraocular pressure, exophthalmos, LCD, and retinal nerve fiber layer thicknesswere evaluated. Results: At baseline, LCD was remarkably shallower in the muscle-dominant group than in the fat-dominantgroup (95% confidence interval, p = 0.007). In the muscle-dominant group, LCD showed no definite change aftersurgery. However, the fat-dominant group showed temporary posterior displacement of the lamina cribrosaat 1-month postoperation that was reversed to baseline at 3 months postoperation (95% confidence interval, p< 0.01). Conclusions: The lamina cribrosa was anteriorly displaced preoperatively, and its position was nearly unchangedafter the surgery, especially in association with extraocular muscle enlargement. An enlarged extraocularmuscle could reduce the pressure-relieving effect of orbital decompression around the scleral canal inpatients with GO.
Abstract
Purpose: We sought to investigate the effects of Graves’ orbitopathy (GO) and orbital decompression on laminacribrosa depth (LCD) using spectral-domain optical coherence tomography. Methods: Forty eyes that underwent orbital decompression to relieve compressive optic neuropathy or correctdisfiguring exophthalmos in the context of GO were included. Subjects were imaged with spectral-domain opticalcoherence tomography before surgery and at 1 and 3 months after surgery, at which the examiner measuredthe LCD (distance from the anterior surface of the lamina cribrosa to the Bruch membrane opening line)and peripapillary retinal nerve fiber layer thickness. Subjects were divided into two groups—a muscle-dominantgroup composed of patients who had extraocular muscle enlargement on preoperative orbital computedtomography scan and a fat-dominant group composed of patients who did not show extraocular muscle enlargementon preoperative orbital computed tomography scan—and subgroup analysis was performed. Preoperativeand postoperative intraocular pressure, exophthalmos, LCD, and retinal nerve fiber layer thicknesswere evaluated. Results: At baseline, LCD was remarkably shallower in the muscle-dominant group than in the fat-dominantgroup (95% confidence interval, p = 0.007). In the muscle-dominant group, LCD showed no definite change aftersurgery. However, the fat-dominant group showed temporary posterior displacement of the lamina cribrosaat 1-month postoperation that was reversed to baseline at 3 months postoperation (95% confidence interval, p< 0.01). Conclusions: The lamina cribrosa was anteriorly displaced preoperatively, and its position was nearly unchangedafter the surgery, especially in association with extraocular muscle enlargement. An enlarged extraocularmuscle could reduce the pressure-relieving effect of orbital decompression around the scleral canal inpatients with GO.
참고문헌 (24)
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