Visualization of the Lamina Cribrosa of Sclera Using Optical Coherence Tomography. The Opportunities and Prospects for Diagnostics (Review)

The lamina cribrosa of the sclera is a multilayer structure consisting of layers of connective tissue represented by collagen of various types. The ratio of collagen fibers I, II and IV types, as well as elastin protein provide support and elastic properties of the lamina cribrosa. Increased intraocular pressure on the background of involutional changes in the composition of the connective tissue of the lamina cribrosa leads to deformation of the latter, compression of nerve fibers passing through the holes in the lamina cribrosa and violation of the axoplasmic current. Modern high-resolution optical coherence tomographs allow to visualize the confines of the lamina cribrosa, and the standard software integrated into each device allows to measure the parameters of the lamina cribrosa. The visualization of the lamina cribrosa in the early stages of glaucoma due to the severity of the pre-laminar tissue and the screening of the surface of the lamina cribrosa is still a problem. The presented review contains the results of studies of various ophthalmologists from different countries. The dependence of such parameters of the lamina cribrosa as depth, thickness, angle of inclination and curvature on the increased of intraocular pressure and the stage of glaucoma process was found. These studies confirm the possibility of visualization of the lamina cribrosa, open prospects in the study of the pathogenesis of glaucoma and expand the possibilities in the search for new methods of treatment of glaucoma optical neuropathy based on pathogenetic aspects. However, a small number of articles on this subject, found in the literature, and a small sample of the study groups in most works require further study of the visualization of the lamina cribrosa using optical coherence tomography.