The rate of progression of visual field damage differed according to the severity of the initial visual field damage. IOP reductive medication may be effective in preventing glaucomatous visual field progression in patients with NTG.

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BackgroundThe purpose of this study was to investigate the relationship between retrobulbar circulation and visual field change in eyes with primary open-angle glaucoma following unilateral trabeculectomy.MethodsTwenty-one patients with primary open-angle glaucoma were prospectively enrolled. Retrobulbar circulation was evaluated using color Doppler imaging. The peak systolic velocity, end-diastolic velocity, and resistive index were evaluated in the central retinal artery, temporal site of the short posterior ciliary artery (t-SPCA), and nasal site of the short posterior ciliary artery (n-SPCA). Visual field examinations were performed using a Humphrey visual field analyzer before surgery and trimonthly for 12 months postoperatively.ResultsIn the operative eyes, the end-diastolic velocity was significantly increased in the central retinal artery (P = 0.005, analysis of variance), t-SPCA (P = 0.005), and n-SPCA (P = 0.027). The resistive index was significantly decreased in the central retinal artery (P = 0.003), t-SPCA (P = 0.000), and n-SPCA (P = 0.010) postoperatively compared with preoperatively. The nonoperative contralateral eyes did not show a significant change in end-diastolic velocity or resistive index for either the SPCA or central retinal artery. The mean deviation slope in the operative eyes (−0.26 ± 0.64 dB/year) was significantly slower than that in the nonoperative eyes (−0.65 ± 0.70 dB/year; P = 0.047, Mann-Whitney U test).ConclusionThese results suggest that trabeculectomy improves the retrobulbar circulation and prevents the progression of visual field changes in patients with primary open-angle glaucoma.

This is the first case report of a superior segmental optic hypoplasia (SSOH) combined with normal-tension glaucoma accompanied by a progressive glaucomatous visual field defect. A 40-year-old man, incidentally diagnosed as having bilateral SSOH, had disc hemorrhage associated with expansion of the width of a retinal nerve fiber layer defect and deterioration of a visual field defect in the right eye during the follow-up period. His left eye showed a stable visual field. The diurnal variation in intraocular pressure (IOP) showed a higher mean IOP in his right eye compared with his left eye, although both IOPs remained under 21 mmHg.

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