Effect of Trabeculectomy on OCT Measurements of the Optic Nerve Head Neuroretinal Rim Tissue

Sanchez, Facundo Gregorio; Sanders, David; Moon, Jessica; Gardiner, Stuart Keith; Reynaud, Juan; Fortune, Brad; Mansberger, Steven L

doi:10.1016/j.ogla.2019.09.003

Cited by 14 publications

(12 citation statements)

References 41 publications

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“…More recently, Bruch's membrane opening (BMO)-related OCT parameters have enabled the quantification of the NRR tissue of the ONH [13,14]. As expected, the representative parameters-BMO-MRW and BMO-minimum rim area-were reported to increase after trabeculectomy [3,7,11,15].…”

Section: Introductionmentioning

confidence: 67%

“…Reducing intraocular pressure (IOP) from glaucoma filtration surgery is accompanied by dynamic structural changes in the optic nerve head (ONH) [1][2][3][4][5][6][7][8][9][10][11][12]. These changes are called "reversal of disc cupping" because neuroretinal rim (NRR) tissue thickening is noted in funduscopic imaging and confocal scanning laser ophthalmoscopy [4,5,9,10,12].…”

Section: Introductionmentioning

confidence: 99%

“…These changes are called "reversal of disc cupping" because neuroretinal rim (NRR) tissue thickening is noted in funduscopic imaging and confocal scanning laser ophthalmoscopy [4,5,9,10,12]. Since optical coherence tomography (OCT) became available, several studies have been conducted on the detailed structural changes in the ONH and peripapillary retinal nerve fiber layer (RNFL) thickness after glaucoma filtration surgery [1][2][3]7,8,11]. Studies using OCT have found that the lamina cribrosa (LC) depth decreased after trabeculectomy, whereas the peripapillary RNFL thickness was unchanged [2,3,7].…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Increased Neuroretinal Rim Thickness Measured Based on Bruch’s Membrane Opening-Minimum Rim Width after Trabeculectomy

Park

Cha

2021

JCM

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Purpose: To investigate the factors associated with an increase in the neuroretinal rim (NRR) thickness measured based on Bruch’s membrane opening-minimum rim width (BMO-MRW) after trabeculectomy in patients with primary open-angle glaucoma (POAG). Methods: We analyzed the BMO-MRW using spectral-domain optical coherence tomography (SD-OCT) of patients with POAG who underwent a trabeculectomy for uncontrolled intraocular pressure (IOP) despite maximal IOP reduction treatment. The BMO-MRW was measured before and after trabeculectomy in patients with POAG. Demographic and systemic factors, ocular factors, pre- and post-operative IOP, and visual field parameters were collected, together with SD-OCT measurements. A regression analysis was performed to investigate the factors that affected the change in the BMO-MRW after the trabeculectomy. Results: Forty-four eyes of 44 patients were included in the analysis. The IOP significantly decreased from a preoperative 27.0 mmHg to a postoperative 10.5 mmHg. The mean interval between the trabeculectomy and the date of post-operative SD-OCT measurement was 3.3 months. The global and sectoral BMO-MRW significantly increased after trabeculectomy, whereas the peripapillary retinal nerve fiber layer thickness did not show a difference between before and after the trabeculectomy. Younger age and a greater reduction in the IOP after the trabeculectomy were significantly associated with the increase in the BMO-MRW after trabeculectomy. Conclusions: The NRR thickness measured based on the BMO-MRW increased with decreasing IOP after trabeculectomy, and the increase in the BMO-MRW was associated with the young age of the patients and greater reduction in the IOP after trabeculectomy. Biomechanically, these suggest that the NRR comprises cells and substances that sensitively respond to changes in the IOP and age.

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Section: Introductionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Increased Neuroretinal Rim Thickness Measured Based on Bruch’s Membrane Opening-Minimum Rim Width after Trabeculectomy

Park

Cha

2021

JCM

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“…It has already been shown that IOP lowering can lead to a transient increase in RNFL thickness in the first weeks after surgery, subsequently returning to preoperative values [ 40 , 41 ]. No measurable change in RNFL thickness could be found in the short term (1–2 months) after medically or surgically induced reduction in IOP [ 42 ] or in the short and medium term (3 or 6 months) after TE [ 41 , 43 ]. Furthermore, no significant changes in RNFL thickness could be demonstrated during follow-up after implantation of glaucoma drainage devices (Baerveldt and Ahmed drainage devices) using SD-OCT measurements [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Functional Monitoring after Trabeculectomy or XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography and Visual Field Indices—A Retrospective Comparative Cohort Study

Schargus

Busch

Rehák

et al. 2021

Biology

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The aim of this study was to compare the efficacy of trabeculectomy (TE), single XEN microstent implantation (solo XEN) or combined XEN implantation and cataract surgery (combined XEN) in primary open-angle glaucoma cases, naïve to prior surgical treatment, using a monocentric retrospective comparative cohort study. Intraocular pressure (IOP) and the number of IOP-lowering drugs (Meds) were monitored during the first 24 months after surgery. Further disease progression was monitored using peripapillary retinal nerve fiber layer (RNFL) thickness examinations using spectral domain optical coherence tomography (OCT) as well as visual acuity (VA) and visual field (VF) tests. In the TE group (52 eyes), the mean IOP decreased from 24.9 ± 5.9 to 13.9 ± 4.2 mmHg (p < 0.001) and Meds decreased from 3.2 ± 1.2 to 0.5 ± 1.1 (p < 0.001). In the solo XEN (38 eyes) and the combined XEN groups, the mean IOP decreased from 24.1 ± 4.7 to 15.7 ± 3.0 mmHg (p < 0.001) and 25.4 ± 5.6 to 14.7 ± 3.2 mmHg (p < 0.001), while Meds decreased from 3.3 ± 0.8 to 0.8 ± 1.2 (p < 0.001) and 2.7 ± 1.2 to 0.4 ± 1.0 (p < 0.001), respectively. The VF and VA indices showed no sign of further deterioration, the RNFL thickness further decreased in all treatment groups after surgery. TE and XEN led to comparable reductions in IOP and Meds. Although the VA and VF indices remained unaltered, the RNFL thickness continuously decreased in all treatment groups during the 24-month follow-up.

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“…However, complications associated with TLE, such as loss of visual acuity, hypotony, infection, cataracts, bleb leakage, and cataract progression, among others, have discouraged some surgeons from practicing this procedure [5]. Nevertheless, TLE surgery may benefit patients by decreasing the depth of the lamina cribrosa (reversal of cupping) and increasing the minimum rim width and area of the optic disc [6][7][8][9][10]. Additionally, TLE may slow the rate of perimetric decay from glaucoma and improve the long-term cell function of the retinal ganglion cells [11].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up After Successful Trabeculectomy: A Case Report of Reversal of Cupping and Recovery of Visual Field Progression

Nakakura

Asaoka²,

Kiuchi³

2021

Cureus

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Glaucoma is one of the leading causes of blindness worldwide, and reduction of intraocular pressure (IOP) is the only available evidence-based treatment that reduces visual field deterioration in glaucoma. We present a representative case of structural recovery and recovery of visual field progression after successful trabeculectomy (TLE) with long-term follow-up. A 35-year-old woman with glaucoma visited our hospital in 2008. The IOP in her right eye was 11 mmHg at the first visit, and subsequently increased to values in the high teens to 20 mmHg despite treatment with anti-glaucoma eye drops. During this period, the progression of this eye’s visual field deterioration was fast (mean deviation [MD] slope = −0.63 dB/year) and the optic disc cupping was advanced. In the seven-year period after successful TLE in 2014, the IOP declined to between 8 and 12 mmHg without any anti-glaucoma medication. During the first two years after TLE, the MD values were poorer than those before TLE. However, by 2020, MD values improved gradually to a state better than that before the surgery (MD slope during this period was +0.75 dB/year). The appearance of the optic disc was monitored using fundus photography, which showed optic disc morphological changes during topical glaucoma medication before and after TLE. In particular, a remarkable reversal of optic disc cupping enlargement started at two weeks after TLE, and the optic disc shape in 2021 was similar to that in 2008. Minimally invasive glaucoma surgeries are often preferred; however, our findings suggest that successful TLE followed by long-term rigorous IOP control can result in structural recoveries. Additionally, despite the deterioration in visual field in the early years after TLE, in the long term, it may settle down to the same level before the surgery with recovery of visual field progression, which may be a part of functional recovery.

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Effect of Trabeculectomy on OCT Measurements of the Optic Nerve Head Neuroretinal Rim Tissue

Cited by 14 publications

References 41 publications

Factors Associated with Increased Neuroretinal Rim Thickness Measured Based on Bruch’s Membrane Opening-Minimum Rim Width after Trabeculectomy

Factors Associated with Increased Neuroretinal Rim Thickness Measured Based on Bruch’s Membrane Opening-Minimum Rim Width after Trabeculectomy

Functional Monitoring after Trabeculectomy or XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography and Visual Field Indices—A Retrospective Comparative Cohort Study

Long-Term Follow-Up After Successful Trabeculectomy: A Case Report of Reversal of Cupping and Recovery of Visual Field Progression

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