Three-Dimensional Ultrasound Elastography Detects Age-Related Increase in Anterior Peripapillary Sclera and Optic Nerve Head Compression During IOP Elevation

PURPOSE. High-frequency ultrasound elastography offers a tool to resolve the complex and heterogeneous deformation through the full thickness of the optic nerve head (ONH) and peripapillary sclera (PPS). Using this tool, we quantified the three-dimensional deforma-tion of the ONH and PPS in human donor eyes and evaluated age-associated changes.METHODS. The ONH and PPS in 15 human donor globes were imaged with a 50-MHz ultrasound probe while increasing intraocular pressure (IOP) from 15 to 30 mm Hg. Tissue displacements were obtained using correlation-based ultrasound speckle tracking. Three-dimensional spherical strains (radial, circumferential, meridional, and respective shear strains) were calculated for the ONH and PPS volumes segmented from three-dimensional ultrasound images. Age-related trends of different strains in each region of interest were explored.RESULTS. The dominant form of IOP-induced deformation in the ONH and PPS was radial compression. High-magnitude localized out-of-plane shear strains were also observed in both regions. Most strains were concentrated in the anterior one-half of the ONH and PPS. The magnitude of radial and volumetric strains increased with age in the anterior ONH and anterior PPS, indicating greater radial compression and volume loss during IOP elevation in older age.CONCLUSIONS. The age-associated increase of radial compression, the predominant form of IOP-induced deformation in anterior ONH and PPS, may underlie age-associated glau-coma risk. High-frequency ultrasound elastography offers a useful tool to quantify all types of deformation comprehensively in all regions of ONH and PPS, which may improve our understanding of the biomechanical factors contributing to glaucoma risk.