Changes in choroidal area after intraocular pressure reduction following trabeculectomy

Kojima, Hirokazu; Hirooka, Kazuyuki; Nitta, Eri; Ukegawa, Kaori; Sonoda, Shozo; Sakamoto, Taiji

doi:10.1371/journal.pone.0201973

Cited by 7 publications

(24 citation statements)

References 22 publications

(27 reference statements)

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“…We previously reported that increases in the luminal areas that led to increases in the macular and peripapillary choroidal areas were related to reductions in the IOP that occurred at 2 weeks after trabeculectomy. 15 In the current study, however, increases in the interstitial areas that led to increases in the macular and peripapillary choroidal areas were due to a reduction in the IOP at 1 year after the initial trabeculectomy. Furthermore, our previous study showed that the rate of increase in the macular choroidal interstitial area or luminal area at 2 weeks after trabeculectomy was 111.2% or 118.6%, respectively, while the rate of increase for the peripapillary choroidal interstitial area or luminal area was 112.0% or 128.2%, respectively.…”

Section: Discussioncontrasting

confidence: 61%

“…Furthermore, we recently reported that the increases in the macular and peripapillary choroidal areas that were caused by the reduction in the IOP at 2 weeks after trabeculectomy were correlated with the subsequent changes in the IOP. 15 In contrast, although there were short-term (7 days) increases in the choroidal thickness following trabeculectomy in PACG, these changes were found not to be related to either a decrease in the IOP or shortened axial length. 12 Usui et al 17 additionally reported that while the choroid was thicker, the axial length was shorter, and the IOP was lower at 6 days after trabeculectomy, there was no correlation in POAG patients for the IOP changes and the changes in the choroidal thickness at the subfovea.…”

Section: Discussionmentioning

confidence: 71%

“…In line with the methodology of our previous studies, a masked procedure was used for all of the measurements. 15,16 All eyes were examined without mydriasis.…”

Section: Methodsmentioning

confidence: 99%

“…However, our recent investigation examined a 1,500 μm wide macular choroidal area and a 1.7 mm area around the optic nerve disc center in the peripapillary choroidal area. 15,16 In contrast to other previous studies, our use of an increased measurement area made it possible to collect greater amounts of information from the choroid. Furthermore, we recently found that the increases that occurred at 2 weeks after trabeculectomy in the macular and peripapillary choroidal areas due to increases in the luminal areas were related to the reduction in the IOP that occurred after the surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, we recently found that the increases that occurred at 2 weeks after trabeculectomy in the macular and peripapillary choroidal areas due to increases in the luminal areas were related to the reduction in the IOP that occurred after the surgery. 15 However, there is also the possibility that this increase could have been associated with inflammation. To definitively determine the effect of IOP changes on the choroidal area, a long-term follow-up is required.…”

Section: Introductionmentioning

confidence: 99%

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Changes choroidal area following trabeculectomy: long-term effect of intraocular pressure reduction

Kojima

Hirooka

Sonoda

et al. 2018

Preprint

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24Purpose: To investigate the long-term effects of intraocular pressure (IOP) changes 25 after trabeculectomy on the macular and peripapillary choroidal areas. 26 Methods: This prospective longitudinal study examined 30 eyes of 30 patients with 27 glaucoma that was uncontrolled by medical therapy. At 1 day before and at 1 year after 28 the trabeculectomy surgery, macular and peripapillary choroidal images were recorded 29 by enhanced depth imaging optical coherence tomography (EDI-OCT). Luminal and 30 interstitial areas were converted to binary images using the Niblack method. Factors 31 influencing the macular choroidal and peripapillary area were examined by multivariate 32 analysis. 33 Results: After trabeculectomy, the mean IOP was 10.8±3.2 mmHg compared to 34 17.8±7.2 mmHg at baseline (P < 0.001). The total macular choroidal area after the 35 surgery increased from 317,735±77,380 to 338,120±90,700 μm 2 , while the interstitial 36 area increased from 108,598±24,502 to 119,172±31,495 μm 2 (all P < 0.05). The total 37 peripapillary choroidal area after the surgery also increased from 1,557,487±431,798 to 38 1,650,253±466,672 μm 2 , while the interstitial area increased from 689,891±149,476 to 39 751,816±162,457 μm 2 (all P < 0.05). However, there were no significant differences 40 observed in the luminal area before and after the surgery. A decrease in the IOP was 41 among the factors associated with the changes in the peripapillary choroidal area. 42 Conclusions: IOP reductions after trabeculectomy led to increases in the macular and 43 peripapillary choroidal areas for at least 1 year postoperative. Increases in the interstitial 44 areas were the primary reason for observed changes in the choroidal area after 45 trabeculectomy. 48 the choroid, 1-3 this suggests that it may play an important role in glaucoma. 4-6 Even 49 though indocyanine green angiography has traditionally been used to visualize 50 choroidal vasculature, 7 other methods, such as optical coherence tomography (OCT) 51 have also been used to study choroidal morphology. However, potential problems with 52 these previous methods have led to the development of the enhanced depth imaging 53 (EDI) spectral domain OCT method, which makes it possible to perform in vivo 54 cross-sectional imaging of the choroid. 8 55The exact mechanism of glaucomatous optic neuropathy remains unknown, 56 even though glaucoma is one of the leading causes of blindness worldwide. As it has 57 been shown that progression of glaucoma is due to an elevated intraocular pressure 58 (IOP), many studies have demonstrated the benefit of decreasing the IOP. 9,10 In order to 59 reduce the IOP in glaucoma, trabeculectomy has been used and remains one of the most 60 commonly performed filtration surgeries. Several investigations have reported increases 61 in the subfoveal and peripapillary choroidal thicknesses in primary open-angle 62 glaucoma (POAG) and in primary angle closure glaucoma (PACG) after 63 trabeculectomy-caused IOP reductions. 11-13 Zhang et al. 14 recently found that ...

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 71%

“…In line with the methodology of our previous studies, a masked procedure was used for all of the measurements. 15,16 All eyes were examined without mydriasis.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes choroidal area following trabeculectomy: long-term effect of intraocular pressure reduction

Kojima

Hirooka

Sonoda

et al. 2018

Preprint

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Relationship Between Changes in the Choroidal Structure and Blood Flow of the Macula After Trabeculectomy

Takamatsu

Higashide

Takeshima³

et al. 2021

Trans. Vis. Sci. Tech.

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Peripapillary and macular choroidal area in patients with normal-tension glaucoma

et al. 2018

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PurposeTo evaluate normal and normal-tension glaucoma (NTG) eyes for differences in peripapillary and macular choroidal area measurements.MethodsThis cross-sectional comparative study enrolled 52 normal subjects and 35 NTG patients. Peripapillary and macular choroidal images were recorded by enhanced depth imaging optical coherence tomography (EDI-OCT), with conversion of the luminal and interstitial areas to binary images performed using the Niblack method.ResultsWhile there was a significant difference between normal subjects and NTG patients for the peripapillary choroidal area (1,853,672 ± 626,501 μm2 vs. 1,606,448 ± 418,214 μm2, P = 0.047), there were no significant differences between the normal subjects and NTG patients observed for the macular choroidal area (345,365 ± 119,248 μm2 vs. 316,442 ± 85,732 μm2, P = 0.23). In the NTG patients, multivariate regression analysis demonstrated a correlation between the macular choroidal area and the axial length (β = -0.345, P = 0.04). Furthermore, there was also a significant correlation between the peripapillary choroidal area and the age of the NTG patients (β = -0.469, P = 0.004). In addition, there was no relationship between the glaucoma severity and the peripapillary and macular choroidal areas in the NTG patients.ConclusionsThere was no correlation between the peripapillary choroidal area and glaucoma severity in NTG patients, even though the area was smaller in these patients.

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Changes in choroidal area after intraocular pressure reduction following trabeculectomy

Cited by 7 publications

References 22 publications

Changes choroidal area following trabeculectomy: long-term effect of intraocular pressure reduction

Changes choroidal area following trabeculectomy: long-term effect of intraocular pressure reduction

Relationship Between Changes in the Choroidal Structure and Blood Flow of the Macula After Trabeculectomy

Peripapillary and macular choroidal area in patients with normal-tension glaucoma

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