Lamina Cribrosa Strain as a Glaucoma Prognostic Factor: The STRAIN Study Methodology and Initial Outcomes

In 205 eyes from 119 adults with open angle glaucoma, lamina cribrosa strain measured by DVC is tensile with IOP decrease and compressive with IOP increase, with mean Emax 1.09%.

• Why it matters: The study addresses uncertainty about how lamina cribrosa biomechanics respond to short-term IOP changes and which patient factors are linked to that response in glaucoma.
• What they did: Patients temporarily stopped ≥1 eye drop, initiated an eye drop, or underwent selective laser trabeculoplasty to alter IOP; OCT ONH scans before and up to several weeks after were analyzed with digital volume correlation.
• The result: Axial strain increased quadratically with IOP change; older age related to greater tensile circumferential strain (p=0.02) and lower Gamma max (p=0.01), and thinner inferior-quadrant RNFL predicted smaller Gamma max for a given IOP change (p=0.02).

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