Focal Lamina Cribrosa Defect in Myopic Eyes With Nonprogressive Glaucomatous Visual Field Defect

Purpose: To investigate focal lamina cribrosa (LC) defect that spatially correspond to the nonprogressive glaucomatous visual field defect (VFD) in myopic subjects. Design: Case-control study. Subjects: We included 159 myopic eyes with glaucomatous VFD under treatment and followed up for 7 years. Methods: Serial enhanced-depth imaging spectral-domain optical coherence tomography B-scans of the optic discs were acquired at the end of the follow-up and reviewed for the LC defect. Nonprogressive VFD was defined as having ≤1 progressing point of Humphrey visual field, with a slope calculated using pointwise linear regression worse than −1.0 dB/year at P <.01. Eyes were classified as having either progressive or nonprogressive VFD, and associating factors were evaluated. Results: Sixty-four subjects (40.3%) exhibited nonprogressive VFD with mean deviation change −0.06 ± 0.22 dB/year. Multivariate logistic regression analysis revealed that presence of LC defect was significantly associated with nonprogressive VFD (odds ratio, 3.96; P =.002). The location of LC defect corresponded spatially to the location of VFD. Nonprogressive eyes with LC defect exhibited lower baseline intraocular pressure (IOP) (16.6 mm Hg vs 21.0 mm Hg, P =.0030) and smaller percentage of IOP change (12.9% vs 30.5%, P <.0001) than those without LC defect, but greater myopic optic disc deformation (10.1 degrees vs 1.2 degrees in torsion angle, P <.0001). When the eyes with LC defect had higher baseline IOP, they exhibited progressive VFD. Conclusions: In myopic eyes, there are specific patters of LC defect that are suggested to be associated with nonprogressive glaucomatous VFD.