Key morphological determinants of optic nerve head biomechanics

 

Glaucoma is closely linked to optic nerve head (ONH) damage, particularly within the lamina cribrosa (LC).

Recent advances in optical coherence tomography (OCT) imaging and deep learning-based segmentation enable accurate reconstruction of patient-specific ONH geometries.

OCT-based approaches can directly quantify ONH biomechanics and LC strain, providing critical insights into the mechanical behaviour of ocular tissues.

Li and associates have developed an automated pipeline that converts routine OCT into patient‑specific finite element (FE) models and quantifies biomechanical and morphological determinants based on the unique individual ONH structures.

This study used OCT images of the ONH from a large cohort of healthy individuals and glaucoma subjects. The overall workflow followed a sequential pipeline.

Collectively, these results demonstrate the capability of the automated pipeline to (1) robustly segment ONH tissues from routine OCT images, (2) extract a comprehensive set of morphological parameters, (3) quantify LC strain across a large cohort, and (4) identify key determinants of biomechanical response through both statistical and machine learning approaches.

In the study, LC depth showed the strongest linear association with LC strain (r = −0.31). Other parameters with smaller associations included BMO radius (r = 0.17), pre-lamina volume (r =  −0.14) and mean choroidal thickness (r = −0.12). 

After adjusting for age and gender, glaucomatous eyes exhibited significantly lower LC strain than healthy eyes (coefficient = 0.0018, p = 0.011), suggesting potential tissue remodelling. 

The pre-lamina depth, LC curvature, BMO radius, and LC depth were also found to be influential predictors for ONH morphological changes, despite modest explained variance.

REFERENCE:

Li, Q., Zhan, B., Liu, T. et al. An automated optical coherence tomography to finite element analysis pipeline reveals key morphological determinants of optic nerve head biomechanics in glaucoma. Eye 40, 238–244 (2026).