Reversal of Glaucomatous Cupping in Adults

Pederson, Jonathan E.; Herschler, Jonathan

doi:10.1001/archopht.1982.01030030428008

Cited by 70 publications

(39 citation statements)

References 10 publications

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“…In patients with glaucoma, sudden hypotony has been reported to produce disk edema resulting in transient reduction in optic CV within the first or second month after glauco ma surgery [15][16][17], This transient improve ment in the disk appearance during hypotony should be accompanied by venous engorge ment and blurred disk margins [17]. In our series, since the time interval of the maximum reversal of each optic disk parameter was less than 2 months in most cases, there is a possibil ity that the disk edema might have been the cause of cupping reversal.…”

Section: Discussionsupporting

confidence: 43%

Reversal of Cupping in Experimental Glaucoma

Shirakashi¹,

Nanba²,

Iwata³

1991

Ophthalmologica

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We studied the change in the optic disk topography during spontaneous pressure reduction in laser-induced primate glaucoma (7 eyes, follow-up of 20 weeks) using computerized image analysis (vertical and horizontal cup-to-disk ratios CDR(V), CDR(H); neuroretinal rim area/disk area; cup volume/disk area). A significant correlation was found between the percent pressure reduction and the percent reversal in each disk parameter. There was no significant difference in the percent reversal between CDR(V) and CDR(H). These results suggest that reversal of cupping may depend on the percent pressure reduction, and may occur symmetrically in primate glaucoma.

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Section: Discussionsupporting

confidence: 43%

Reversal of Cupping in Experimental Glaucoma

Shirakashi¹,

Nanba²,

Iwata³

1991

Ophthalmologica

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“…The exception was some patients undergoing glaucoma surgery and experiencing a marked drop in intraocular pressure (Pederson & Herschler 1982;Schwartz et al 1985;Katz et al 1989;Parrow et al 1992;Park et al 1997;Lesk et al 1999;Kotecha et al 2001Kotecha et al , 2009Wu et al 2002;Tavares et al 2006;Harju et al 2008;Yuen & Buys 2010). These patients could also show an improvement in function (Jindal et al 2011).…”

Section: Introductionsupporting

confidence: 41%

“…It has been discussed that in these very young children, the optic nerve scleral canal was still elastic, so that a relatively short-term increase in intraocular pressure could lead to a reversible enlargement of the optic disc, and because of the correlation between disc size and cup size, secondarily to a reversible enlargement of the optic cup (Quigley 1977;Robin & Quigley 1979). Clinical studies on adult patients with glaucoma have described an increase in the neuroretinal rim and, complementarily, a decrease in the optic cup in adult patients after reduction in an highly elevated intraocular pressure (Pederson & Herschler 1982;Schwartz et al 1985;Katz et al 1989;Parrow et al 1992;Park et al 1997;Lesk et al 1999;Kotecha et al 2001Kotecha et al , 2009Wu et al 2002;Tavares et al 2006;Harju et al 2008;Yuen & Buys 2010). As a corollary, Azuara-Blanco found that a short-term increase in intraocular pressure from about 13 mmHg to about 35 mmHg resulted in a significant (p < 0.05) enlargement in the optic disc cupping (Azuara-Blanco et al 1998).…”

Section: Introductionsupporting

confidence: 37%

Optic nerve head morphology in young patients after antiglaucomatous filtering surgery

Panda‐Jonas

Yang

et al. 2013

Acta Ophthalmologica

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. Purpose: To compare the optic nerve head appearance in glaucomatous eyes before and after marked reduction of intraocular pressure (IOP). Methods: The hospital‐based observational case‐series study included selected glaucoma patients for whom optic disc photographs taken before and 1 week to 5 months after surgical reduction of IOP were morphometrically examined. Results: The study included 23 eyes of 16 patients (mean age: 28.7 ± 6.0 years). Mean preoperative IOP was 31.6 ± 7.7 mmHg (22–52 mmHg), and mean IOP drop was 21.5 ± 8.4 mmHg (11–45 mmHg). The horizontal disc diameter decreased significantly (p < 0.001) after surgery, while the vertical disc diameter did not change markedly (p = 0.54). The width of the neuroretinal rim increased significantly in all disc quadrants (all p‐values ≤ 0.01), optic cup depth decreased (p < 0.001), and reflectivity of the inner retinal surface increased significantly (p < 0.001). Some eyes showed a pronounced reduction in beta zone of parapapillary atrophy parallel to an increase in horizontal disc diameter, and some eyes showed an enlargement of beta zone parallel to a reduction in horizontal disc diameter. Conclusions: After marked reduction of high IOP, some eyes of young adult patients with glaucoma can show a horizontal shrinkage of the optic nerve head, in addition to a partial restoration of the neuroretinal rim and a flattening of the optic cup. In addition, beta zone of parapapillary atrophy can decrease or increase, complementarily to changes in the horizontal disc diameter. These findings may be of interest for the biomechanics of the optic nerve head and the precision of imaging techniques.

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“…Estudos têm demonstrado melhora dos tecidos oculares após a redução da Pio em pacientes com glaucoma e em diferentes regiões do campo visual (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(20)(21) . É importante enfatizar, entretanto, que todos os estudos foram baseados na trabeculectomia como o método conseqüentemente a probabilidade de melhora é menor.…”

Section: Discussionunclassified

“…A pressão intraocular (Pio) pode ser considerada como o principal fator de risco para o glaucoma (1) , e sua redução como o único meio efetivo de tratamento (2) , incluindo pacientes com glaucoma de pressão normal (3) . Estudos têm demonstrado melhora na CFNR (4)(5) , no aspecto do disco óptico (6)(7)(8) e no campo visual glaucomatoso (8)(9)(10)(11)(12)(13)(14) após a redução da Pio após a trabeculectomia. Portanto, é racional sugerir que a redução medicamentosa da Pio também conduziria a uma melhora destas estruturas.…”

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