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Editors Selection IGR 23-3

Anatomical structures: Lamina cribrosa: Between two pressures

Comment by Ningli Wang on:

106088 Relative Contributions of Intraocular and Cerebrospinal Fluid Pressures to the Biomechanics of the Lamina Cribrosa and Laminar Neural Tissues, Karimi A; Karimi A; Razaghi R; Rahmati SM et al., Investigative Ophthalmology and Visual Science, 2022; 63: 14

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Karimi et al. investigated the impact of simultaneous IOP and CSFP elevation on both the LC beam and laminar NT stresses and strains. It is indeed a significant paper and an important topic to explore. They found that translaminar pressure (TLP; TLP =IOP-CSFP) plays a prominent role in ONH biomechanics, and the IOP-driven stress, strain, and deformation play a more dominant role than CSFP effects. Also, the results illustrated that the LC beams show greater stresses and lower strains than the interspersed laminar NT, underscoring the critical structural role of the LC beams in protecting axons of the delicate retinal ganglion cells that traverse through the LC pores in the laminar region.

It is worth noting that elevated TLP not only causes relatively higher stresses and strains on LC but also significantly impacts intracellular axonal fluid flow.^1,2 The differences in stresses and strains between LC beams and laminar NT may be correlated with intracellular axonal fluid flow, which may be also important in the pathogenesis and progression of glaucoma. Moreover, the optic disc is a complex 3D structure that can be influenced by interactions between the dura and peripapillary sclera under intracranial pressure,3 which was not accounted for in this study and may affect the accuracy of the results. Also, this study only included three eyes, which may not be representative of the complex 3D structure and interactive effects between various pressures on the optic disc. Therefore, the discussions and conclusion could be further refined.

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