Visual Field Global Indices in Patients with Reversal of Glaucomatous Cupping after Intraocular Pressure Reduction

Tsai, Clark S.; Shin, Dong Ho; Wan, Jim Y.; Zeiter, John H.

doi:10.1016/s0161-6420(91)32118-3

Cited by 50 publications

(39 citation statements)

References 31 publications

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“…9,10 This distortion may be permanent in advanced cases, but there is mounting evidence that in less advanced disease, both the disc and visual field can improve when the IOP is lowered. 26,27 It is postulated that one of the main reasons for an apparent improvement in optic nerve appearance with IOP reduction is a reduction in the posterior bowing of the lamina cribrosa, giving relief to these compressed nerve fibre bundles. 10 Apparent improvement in the appearance of the ONH has been well documented in children.…”

Section: Discussionmentioning

confidence: 99%

“…The stage of disease, the amount of IOP reduction, and the age of the patient probably influence the occurrence of this event, resulting in inconsistent outcomes. The clinical relevance of 'reversal' has not been established with certainty, although reports 5,6 have suggested that there may be an associated improvement of visual function that corresponds to this improvement in disc appearance.…”

Section: Introductionmentioning

confidence: 99%

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Effect of trabeculectomy on RNFL thickness and optic disc parameters using optical coherence tomography

Raghu

Pandav

Kaushik

et al. 2012

Eye

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Purpose To study the change in retinal nerve fibre layer (RNFL) thickness and optic nerve head (ONH) parameters using optical coherence tomography (Stratus OCT 3) after trabeculectomy in adult patients with glaucoma. Methods A total of 17 patients with glaucoma undergoing trabeculectomy were recruited. Average and quadrant RNFL thickness measurements, vertical integrated rim area, horizontal integrated rim width, disc area, cup area, and rim area were measured using Stratus OCT within a week before surgery and at 1 week, 1 and 3 months postoperatively. Main outcome measures were change in RNFL and ONH parameters. Pre-and postoperative values were analysed using the Wilcoxon signed-rank test. Results Intraocular pressure (IOP) reduced from 30.23±9.02 mm Hg preoperatively to 9.52 ±2.42 mm Hg at 1 week, 12.35±4.59 mm Hg at 1 month, and 13.6 ±2.31 mm Hg at 3 months after trabeculectomy. A significant increase in average (P ¼ 0.019) and inferior RNFL (P ¼ 0.038) thickness was observed 1 week after surgery. At 3 months postoperatively, they had reverted to preoperative values. RNFL thickness change had no correlation with IOP change. Mean optic disc cup area decreased from 2.39±0.52 mm 2 preoperatively to 2.14 ± 0.52 mm 2 at 1 week (P ¼ 0.022), 2.22 ± 0.53 mm 2 at 1 month (P ¼ 0.038), and 2.27 ± 0.60 mm 2 at 3 months (P ¼ 0.071). No significant change was found in other ONH parameters. Conclusions Short-term fluctuations were noted in RNFL thickness and ONH postoperatively following glaucoma filtration surgery. RNFL thickness temporarily increased and cup area decreased but the values reverted to normal within 3 months.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of trabeculectomy on RNFL thickness and optic disc parameters using optical coherence tomography

Raghu

Pandav

Kaushik

et al. 2012

Eye

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“…A significant difference in the SAP mean deviation index was found, but not in the pattern standard deviation. Although different studies describe an improvement of visual field after reducing IOP in glaucoma eyes, [6][7][8]18 this improvement has not been reported by other studies. 15,16 Heijl et al 15 analysed 42 glaucoma eyes after laser trabeculoplasty and found no reduction of visual field defects.…”

Section: Discussionmentioning

confidence: 98%

“…2,4,6,7,13,15,16,18 Some possible reasons for the discrepancies found among the studies could be related to sample size, baseline IOP level, disease stage, treatment modality, as well as spontaneous fluctuations of the visual field (long-term fluctuation) and the influence of learning.…”

Section: Discussionmentioning

confidence: 99%

“…4 However, several studies have reported partial recovery from visual field defects in some patients, which is related to the IOP reduction achieved in each eye. [5][6][7][8] During the natural course of glaucomatous optic neuropathy (GON), certain types of functional vision loss may occur earlier than those detected by standard automated perimetry (SAP). 4,9 Alterations in contrast sensitivity (CS) have been observed before any visible nerve fiber layer damage or SAP visual field defects.…”

Section: Introductionmentioning

confidence: 99%

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Changes in visual function after intraocular pressure reduction using antiglaucoma medications

Prata

Piassi

Melo

2008

Eye

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Purpose To evaluate the change in visual function after starting glaucoma treatment and correlate this to a decrease in intraocular pressure (IOP) Conclusions Visual quality perception, visual field mean deviation index, and CS at higher frequencies improve after starting glaucoma therapy. However, no correlation was found between IOP reduction and changes in visual function, and no differences were found in visual function when the three medications studied were compared.

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Intraocular pressure-related pattern of optic disc cupping in adult glaucoma patients

Shin

Lee

Briggs

et al. 1992

Graefe's Arch Clin Exp Ophthalmol

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The pattern of glaucomatous optic disc cupping was investigated in 67 eyes of 67 primary open-angle glaucoma patients with early-to-moderate visual field loss and a wide range of intraocular pressure. We determined the position of the deepest point of the optic disc cup using the Rodenstock Analyzer. This position correlated significantly with intraocular pressure: the deepest point tended to be located below the center of the optic disc at high intraocular pressure and above the center at low intraocular pressure. There was no significant correlation between the position of the deepest cup point along the horizontal axis and intraocular pressure. The position of the deepest point of the cup also correlated significantly with the severity of glaucoma, albeit less strongly than with intraocular pressure: it tended to be in the inferior portion of the disc at an early stage of glaucoma and in the superior portion of the disc at a more advanced stage of glaucoma. Therefore, the inferior portion of the optic nerve head appears to be most yielding to changes of intraocular pressure. These findings are consistent with histologic evidence of the least connective tissue support in the inferoperipheral region of the lamina cribrosa and with greater prevalence of inferior rim loss and corresponding superior visual field defects in early to moderately advanced primary open-angle glaucoma patients.

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Visual Field Global Indices in Patients with Reversal of Glaucomatous Cupping after Intraocular Pressure Reduction

Cited by 50 publications

References 31 publications

Effect of trabeculectomy on RNFL thickness and optic disc parameters using optical coherence tomography

Effect of trabeculectomy on RNFL thickness and optic disc parameters using optical coherence tomography

Changes in visual function after intraocular pressure reduction using antiglaucoma medications

Intraocular pressure-related pattern of optic disc cupping in adult glaucoma patients

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