Horizontal central ridge of the lamina cribrosa and regional differences in laminar insertion in healthy subjects

To assess the general morphology and position of the lamina cribrosa (LC) in healthy subjects using enhanced depth imaging-optical coherence tomography (EDI-OCT). Serial horizontal and vertical B-scans of the optic nerve head (interval between images, approximately 30 μm) were prospectively obtained using EDI-OCT for both eyes of each healthy subject. After delineation of the anterior laminar surface, mean and maximum LC depths were measured in 11 equally spaced horizontal B-scans, and the depth of the anterior LC insertion was measured at 32 points along its circumference (reference plane, Bruch's membrane edges) for one randomly selected eye of each subject. Three-dimensional (3D) images of the anterior laminar surface and the peripapillary sclera were reconstructed from serial horizontal EDI-OCT B-scans to assess the 3D morphology of the anterior laminar surface. Among the 61 eyes (61 subjects) enrolled, 31 were excluded because of poor LC image quality, and 30 were included for analysis (mean age, 40 ± 18 [range, 21-78] years). Both mean and maximum LC depth profiles showed an elevation in the central area and a depression in the superior and inferior midperiphery of the LC. The anterior LC insertion was more posteriorly located in the superior and inferior than in the nasal and temporal regions. Three-dimensional LC images showed a bowtie-shaped horizontal central ridge of the LC. The LC has a central ridge ranging from the temporal to the nasal insertion areas and inserts more posteriorly in the superior and inferior than in the nasal and temporal regions. Further investigation is needed to elucidate the significance of these findings in the pathophysiology of glaucoma.