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1From the Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany; and the 2Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany.
PURPOSE. To evaluate the spatial relationships of the intraocular space, the cerebrospinal fluid space, and the lamina cribrosa in highly myopic eyes.
METHODS. The study included 36 human globes with an axial length of more than 26.5 mm that showed marked glaucomatous optic nerve damage (n = 29; highly myopic glaucomatous group) or in which the optic nerve was affected by neither glaucoma nor any other disease (n = 7; highly myopic normal group). Two nonhighly myopic control groups included 53 globes enucleated because of malignant choroidal melanoma (n = 42; nonhighly myopic normal group) or because of painful absolute secondary angle-closure glaucoma (n = 11; nonhighly myopic glaucomatous group). Anteriorposterior histologic sections through the pupil and the optic disc were morphometrically evaluated.
RESULTS. In both highly myopic groups compared with both nonhighly myopic groups and in the highly myopic glaucomatous group compared with the highly myopic normal group, the lamina cribrosa was significantly (P < 0.001) thinner. Correspondingly, the distance between the intraocular space and the cerebrospinal fluid space was significantly (P < 0.05) shorter in the highly myopic normal group than in the nonhighly myopic normal group and in the highly myopic glaucomatous group than in the highly myopic normal group.
CONCLUSIONS. In highly myopic eyes, the lamina cribrosa is significantly thinner than in nonhighly myopic eyes, which decreases the distance between the intraocular space and the cerebrospinal fluid space and steepens the translaminar pressure gradient at a given intraocular pressure, which may explain the increased susceptibility to glaucoma in highly myopic eyes. As in nonhighly myopic eyes, thinning of the lamina cribrosa gets more pronounced in highly myopic eyes if glaucoma is also present.
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