Macular thickness after intraocular pressure reduction following trabeculectomy

Abstract

Purpose The aim of the study was to assess changes of macular thickness after trabeculectomy and compare them in respect to the usage of preoperative prostaglandins and status of diabetes mellitus. Methods The prospective observational study included 93 glaucomatous eyes (90 patients) that underwent trabeculectomy. 81 (87.1%) patients were on prostaglandins treatment preoperatively. 5 (5.38%) patients had type 2 diabetes. The foveal and sectoral macular thicknesses were measured preoperatively, 1 week, 6 months and 12 months after the surgery using spectral domain optical coherence tomography. Retinal thickness was compared across the follow‐up visits and in respect to the preoperative use of prostaglandins and diabetes. Results There was a reduction in mean ± SD intraocular pressure of 18.5 ± 8.6mmHg 1 week, 15.4 ± 7.9 mmHg 6 months and 14.4 ± 8.3 mmHg 12 months after trabeculectomy (p < 0.001). 1 week postoperatively retinal thickening was observed in all macular subfields (p < 0.001); the central macular thickness increased from 267.23 ± 19.20 μm at baseline to 271.12 ± 19.59 μm. 6 months postoperatively macula remained slightly thicker in central, nasal, inner superior and outer temporal sectors (2.10 ± 5.97 μm, p < 0.001 in central subfield). 12 months after trabeculectomy retina showed thinning in the outer nasal and superior subfields (‐3.54 ± 8.57 μm; ‐1.94 ± 7.02; p < 0.01, respectively). There were no differences in the changes of macular thickness when compared in respect to preoperative prostaglandins (p > 0.05). The retinal changes did not differ between diabetic and nondiabetic patients (p > 0.05). Conclusions Trabeculectomy induced mild macular thickening, more pronounced in the early postoperative period. Neither diabetes nor the use of prostaglandins before surgery had impact on these changes regardless their potency to increase vascular permeability.

Early Macular Thickness Changes after Trabeculectomy and Combined Phaco-Trabeculectomy

“…Such findings in terms of the neutral effect of DM status and prostaglandin drops usage on postoperative macular changes were confirmed in another study by Drukteiniene et al . 13 They studied 93 eyes from 90 patients who underwent trabeculectomy and followed them up to 12 months. They found mild macular thickening, which was more pronounced in the early postoperative period (6 months).…”

“…8 9 In addition, diabetes mellitus (DM) or prostaglandin drops usage before surgery has not been shown to have any impact on these postoperative macular changes. 8 13 However, some studies have shown that early postoperative changes in macular thickness can be different, defined by spectral domain-optical coherence tomography (SD-OCT), in different quadrants of the macula. 14 …”

Influences of Rapamycin on Retinal Ganglion Cells in Rats with Acute High Intraocular Pressure Through Regulating COX-2

“…As a clinically researched blinding disease, glaucoma tends to cause vision loss and even blindness in patients, and studying the physiological and pathological reactions in glaucoma has important implications for the clinical treatment of glaucoma. Acute high intraocular pressure, one crucial pathological process in glaucoma, often results in retinal ganglion cell apoptosis and even necrosis, exacerbating optic nerve damage (9)(10)(11). Studies have unraveled that (12,13) inflammation and cell apoptosis are vital pathological reactions in acute high intraocular high pressure, and in acute high intraocular pressure injury, high intraocular pressure-induced vascular injury and other damage factors cause the increase in the release of local inflammatory factors and other cytokines in the optic nerve.…”