The American Academy of Ophthalmology (AAO) recently took a close look at the literature support for the use of swept-source optical coherence tomography (SS-OCT) for evaluating the lamina cribrosa, particularly in the setting of glaucoma. The AAO found a total of 64 articles that addressed the topic, 29 of which were ultimately included in the review. The studies used SS-OCT to monitor several aspects of the lamina cribrosa, including anterior curvature, depth and insertions; laminar thickness; focal lamina cribrosa defects; and lamina cribrosa microarchitecture.

The literature suggests SS-OCT in the setting of glaucoma often shows posterior migration of the anterior lamina cribrosa insertion and increased thinning and posterior curvature of the lamina cribrosa. Focal lamina cribrosa defects are more common in glaucoma.

The review authors note little evidence exists comparing SS-OCT to spectral domain OCT, but some studies do show little difference in image quality between SS-OCT and enhanced depth imaging OCT.

Ultimately, the report concludes that using SS-OCT to image the lamina shows that “the lamina cribrosa is likely biomechanically active and that significant changes occur in glaucoma.”

Although imaging the lamina cribrosa with SS-OCT may be diagnostically useful in glaucoma, “standardized nomenclature, automated measurements, and longitudinal studies with larger and more diverse sample sizes are needed,” the review concluded. 

Takusagawa HL, Hoguet A, Junk AK, et al. Swept-source optical coherence tomography for evaluating the lamina cribrosa: a report by the American Academy of Ophthalmology. Ophthalmology. April 4, 2019. [Epub ahead of print].