Effects of Deep Optic Nerve Head Structures on Bruch's Membrane Opening- Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer

Mitsuki Kambayashi; Hitomi Saito; Makoto Araie; Nobuko Enomoto; Hiroshi Murata; Tsutomu Kikawa; Kazuhisa Sugiyama; Tomomi Higashide; Atsuya Miki; Aiko Iwase; Goji Tomita; Toru Nakazawa; Makoto Aihara; Kyoko Ohno-Matsui; Tae-Woo Kim; Christopher Kai Shun Leung; Linda M Zangwill; Robert N Weinreb

doi:10.1016/j.ajo.2024.02.017

Effects of Deep Optic Nerve Head Structures on Bruch's Membrane Opening- Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer

Am J Ophthalmol. 2024 Feb 23:263:99-108. doi: 10.1016/j.ajo.2024.02.017. Online ahead of print.

Authors

Mitsuki Kambayashi¹, Hitomi Saito², Makoto Araie³, Nobuko Enomoto⁴, Hiroshi Murata⁵, Tsutomu Kikawa⁶, Kazuhisa Sugiyama⁷, Tomomi Higashide⁷, Atsuya Miki⁸, Aiko Iwase⁹, Goji Tomita¹⁰, Toru Nakazawa¹¹, Makoto Aihara¹, Kyoko Ohno-Matsui¹², Tae-Woo Kim¹³, Christopher Kai Shun Leung¹⁴, Linda M Zangwill¹⁵, Robert N Weinreb¹⁵

Affiliations

¹ From the Department of Ophthalmology (M.K., H.S., M.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
² From the Department of Ophthalmology (M.K., H.S., M.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: hitomi8678@gmail.com.
³ Kanto Central Hospital of the Mutual Aid Association of Public School Teachers (M.A.), Tokyo, Japan.
⁴ Tokyo Teishin Hospital (N.E.), Tokyo, Japan.
⁵ Center Hospital of the National Center for Global Health and Medicine (H.M.), Tokyo, Japan.
⁶ R&D Division (T.K.), Topcon Corporation, Tokyo, Japan.
⁷ Department of Ophthalmology (K.S., T.H.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
⁸ Department of Innovative Visual Science (A.M.), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Myopia Control Research (A.M.), Aichi Medical University Medical School, Nagakute, Japan.
⁹ Tajimi Iwase Eye Clinic (A.I.), Tajimi, Japan.
¹⁰ Department of Ophthalmology (G.T.), Toho University Ohashi Medical Center, Tokyo, Japan.
¹¹ Department of Ophthalmology (T.N.), Graduate School of Medicine, Tohoku University, Sendai, Japan.
¹² Department of Ophthalmology and Visual Science (K.O.-M.), Tokyo Medical and Dental University, Tokyo, Japan.
¹³ Department of Ophthalmology (T.-W.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
¹⁴ Department of Ophthalmology, LKS Faculty of Medicine (C.S.K.L.), the University of Hong Kong, Hong Kong Special Administrative Region, China.
¹⁵ Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology (L.M.Z., R.N.W.), University of California San Diego, La Jolla, CA, United States.

PMID: 38403100
DOI: 10.1016/j.ajo.2024.02.017

Abstract

Purpose: To explore the effects of deep optic nerve head (ONH) structures on Bruch's membrane opening (BMO)-minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) in healthy eyes.

Design: Prospective cross-sectional study.

Methods: Two hundred five healthy eyes of 141 subjects (mean ± standard deviation of age and axial length (AXL): 46.9 ± 10.0 years and 24.79 ± 1.15 mm) were enrolled. Best fit multivariable linear mixed models identified factors associated with BMO-MRW and pRNFLT. Explanatory variables included age, gender, AXL, BMO and anterior scleral canal opening (ASCO) area and ovality, magnitude of BMO and ASCO shift, peripapillary choroidal thickness, lamina cribrosa (LC) parameters, prelaminar thickness, and peripapillary scleral (PPS) angle.

Results: Thinner BMO-MRW was associated with older age, smaller ASCO/BMO offset magnitude, larger BMO area, thinner prelaminar thickness, deeper LC, and thinner pRNFLT (P = .011, <.001, .004, <.001, <.001, <.001 respectively). Thinner pRNFLT was associated with shorter AXL, smaller ASCO area, a more posteriorly bowed PPS, shallower LC and thinner BMO-MRW. (P = .030, .002, .035, .012, <.001 respectively) CONCLUSIONS: BMO-MRW and pRNFLT were influenced by several deep ONH structures such as BMO and ASCO position shift, BMO or ASCO area, prelaminar thickness, PPS bowing and LC depth in addition to patient characteristics such as age and AXL. The degree and/or direction of associations varied between deep ONH structures and BMO-MRW or pRNFLT. Despite both BMO-MRW and pRNFLT being surrogate parameters for RGC loss, a complex relationship with ONH deep-layer morphology was indicated.