Central Retinal Vessel Trunk Location
Overview
The distance between the central retinal vessel trunk exit location and the neuroretinal rim may contribute to the vulnerability of associated glaucomatous neuroretinal rim loss.
Pearls
The central retinal vessel trunk may act as a stabilizing (structural and vascular) element against glaucomatous changes in the lamina cribrosa.1,2,3
Limits mechanical distortion and backward bowing of the lamina cribrosa in glaucoma AND/OR may provide a supportive vascular supply to the adjacent tissue.
The lamina cribrosa shows more backward bowing in the inferior and superior disc sectors than close to the base of the central retinal vessel trunk.
Creates a “W-Shaped” lamina cribrosa appearance.
Example: Superior nasal vessel trunk decentration may lead to more easily deformed inferior temporal sector compared to the superior nasal sector.
The greater the distance between the base of the central retinal vessel trunk and the neuroretinal rim, the greater the associated glaucomatous neuroretinal rim loss, corresponding parapapillary atrophy size and enlargement, and corresponding visual field loss in glaucomatous eyes compared to normal eyes.
The pattern of glaucomatous rim loss may be associated with the distance between the central retinal vessel trunk location and the neuroretinal rim.2,3
The pattern of papillomacular bundle retinal nerve fiber loss is strongly correlated with, and directly proportional to, the location of the central retinal vessel trunk and the papillomacular bundle.4
The pattern of advanced visual field loss is correlated with the location of the central retinal vessel trunk in advanced glaucoma.5
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