Elastosis of the lamina cribrosa in glaucomatous optic neuropathy

The purpose of this study was to determine whether elastotic degeneration o f the elastin component of the lamina cribrosa occurs in optic neuropathy a ssociated with different types of glaucoma. Human optic nerve heads with pr imary open-angle, neovascular, chronic angle closure and pseudoexfoliation glaucoma, and with varying duration of disease were compared with age-match ed normal eyes, using electron microscopy and immunogold labeling of elasti n. The percent area occupied by immunogold-labeled elastin material was det ermined using a digital image analysis system. In all eyes with a history o f glaucoma, elastosis was found in the lamina cribrosa and there was a sign ificantly greater percentage of area occupied by elastin compared with age- matched control eyes (P < 0.0001). Among the glaucomatous eyes, pseudoexfol iation glaucoma had the largest area of elastosis, followed by primary open -angle and secondary glaucoma (neovascular and chronic angle closure). In a ll glaucoma samples, large, confluent elastin aggregates of irregular and v aried shapes (elastosis) were observed in the lamina cribrosa and insertion region. These results demonstrate that glaucomatous optic neuropathy is as sociated with elastosis of the lamina cribrosa, which may contribute to the changes in compliance of the optic nerve heads of glaucomatous eyes. (C) 1 998 Academic Press.