Baseline Lamina Cribrosa Curvature and Subsequent Visual Field Progression Rate in Primary Open-Angle Glaucoma

Ha, Ahnul; Kim, Tai Jun; Girard, M; Mari, Jean-Martial; Kim, Young Kook; Park, Ki Ho; Jeoung, Jin Wook

doi:10.1016/j.ophtha.2018.05.017

Cited by 33 publications

(50 citation statements)

References 33 publications

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“…This makes lamina cribrosa parameters an unlikely candidate for sufficient structural progression analysis after trabeculectomy. This is in contrary to a study by Ha and co-workers, where they showed that the baseline mean anterior laminar cribrosa insertion depth was correlated with the rate of VF deterioration 32 . One plausible explanation may be related to the severity of glaucomatous damage.…”

Section: Discussioncontrasting

confidence: 99%

One year structural and functional glaucoma progression after trabeculectomy

Chua

Kadziauskiene

Wong

et al. 2020

Sci Rep

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We evaluated the changes in visual field mean deviation (VF MD) and retinal nerve fibre layer (RNFL) thickness in glaucoma patients undergoing trabeculectomy. one hundred patients were examined with VF and spectral-domain optical coherence tomography (OCT) before trabeculectomy and 4 follow-up visits over one year. Linear mixed models were used to investigate factors associated with VF and RNFL. VF improved during the first 3 months of follow-up (2.55 ± 1.06 dB/year) and worsened at later visits (−1.14 ± 0.29 dB/year). RNFL thickness reduced by −4.21 ± 0.25 µm/year from 1st month of follow-up. Eyes with an absence of initial VF improvement (β = 0.64; 0.30-0.98), RNFL thinning (β = 0.15; 0.08-0.23), increasing intraocular pressure (IOP; β = −0.11; −0.18 to −0.03) and severe glaucoma (β = −10.82; −13.61 to −8.02) were associated with VF deterioration. Eyes with VF deterioration (β = 0.19; 0.08-0.29), increasing IOP (β = −0.09; −0.17 to −0.01), and moderate (β = −6.33; −12.17 to −0.49) or severe glaucoma (β = −19.58; −24.63 to −14.52) were associated with RNFL thinning. Changes in RNFL structure and function occur over a 1-year follow-up period after trabeculectomy.Early VF improvement is more likely to occur in patients with mild/moderate glaucoma, whereas those with severe glaucoma show greater decline over one year. Our findings indicate that progression is observable using OCT, even in late-stage glaucoma.Clinically, reduction of intraocular pressure (IOP) remains the only proven treatment for glaucoma 1-3 . Landmark glaucoma randomized clinical trials have confirmed the value of lowering IOP in delaying visual field (VF) progression 1-5 . Interestingly, recent studies 6-8 have reported that the surgical lowering of IOP in glaucoma can result in the improvement of VF, which lends support to the preliminary data reported by Katz and Spaeth, who demonstrated reversal of structural change and field loss in newly diagnosed patients after commencement of treatment 9,10 .Apart from functional changes, others have examined structural changes after trabeculectomy and their potential association with functional changes. The association between structural glaucomatous damage with VF decline after trabeculectomy is complex. The MoreFlow Medical Research Council 5-Fluorouracil (5-FU) study reported that out of 250 eyes, 20 eyes showed structural progression, 35 eyes showed VF progression, and 15 eyes showed both over a five years period 11 . In the Collaborative Initial Glaucoma Treatment Study (CIGTS), VF worsening was significantly associated with enlargement of the optic cup, but reversal of cupping was not associated with improvement of the VF 12 . Other studies reported an early increase in retinal nerve fiber layer (RNFL) thickness after trabeculectomy, but did not investigate the relation with VF changes [13][14][15][16][17] . Also, these studies have used the older time-domain optical coherence tomography (OCT) 14,16 , stereoscopic optic disc photographs 12,15 scanning laser polarimetry 17 , or Heidelberg Retina Tom...

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Section: Discussioncontrasting

confidence: 99%

One year structural and functional glaucoma progression after trabeculectomy

Chua

Kadziauskiene

Wong

et al. 2020

Sci Rep

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“…Remodeling of the lamina cribrosa is a well-described component of the glaucomatous process and has been studied in primate models,3–10 human donor tissues,11–14 and more recently via in vivo imaging studies 15–21. A significant posterior shift in the position of the lamina cribrosa has been demonstrated at a very early stage of glaucoma (preceding retinal nerve fiber layer loss) in the chronically elevated intraocular pressure (IOP) nonhuman primate model 6.…”

mentioning

confidence: 99%

Racial Differences in the Association of Anterior Lamina Cribrosa Surface Depth and Glaucoma Severity in the African Descent and Glaucoma Evaluation Study (ADAGES)

Girkin

Fazio

Bowd

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PurposeTo determine if variation in anterior lamina cribrosa surface depth (ALCSD) differs between glaucoma patients of African (AD) and European descent (ED).MethodsA total of 178 eyes from 123 glaucoma patients in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Innovations in Glaucoma Study (DIGS) were included. ALCSD and choroidal thickness were measured using the San Diego Automated Layer Segmentation Algorithm (SALSA). ALCSD was defined by both Bruch's membrane opening (BMO)-based (ALCSD-BMO) and scleral-based (ALCSD-Scl) reference planes. Racial differences in ALCSD were evaluated using cross-sectional univariate and multivariable models.ResultsA deeper ALCSD-Scl was found in males (52.4 μm, P = 0.0401), AD individuals (78.6 μm, P = 0.0004), younger individuals (−3.1 μm/year, P < 0.0213), and eyes with larger discs (81.0 μm/mm2, P = 0.024), increased visual field loss (mean defect, MD: −6.4 μm/dB [decibel], P = 0.0106), and higher intraocular pressure (IOP: 14.1 μm/mm Hg, P = 0.0256). Significant deepening of ALSCD was observed with increasing IOP and visual field severity only in the AD group. Race modified the relationship between ALCSD-Scl and age (P = 0.0145) with ALCSD-Scl in AD individuals becoming more shallow with increasing age (−3.1 μm/year, P = 0.0213), while there was no significant association in the ED group (2.1 μm/mm Hg, P < 0.2026).ConclusionsThis study demonstrates that a deeper ALCSD, regardless of the ALCSD reference plane used, is associated with more severe glaucoma and higher IOP in the ADAGES cohort, particularly in individuals of AD. These results suggest that characterizing ALCSD morphology and its relationships to IOP, aging, and glaucoma progression may help explain racial differences in disease susceptibility.

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“…Determination of functional PACG progression was based on two primary criteria [31, 32]. The first included the clinical diagnosis of medically uncontrollable IOP, which included all patients who received ≥1 topical glaucoma medication(s) during analysis, or in whom IOP was not lowered by at least 20% from the baseline IOP or was maintained at >21 mmHg.…”

Section: Methodsmentioning

confidence: 99%

Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study

Shao

Cao

et al. 2019

Oxidative Medicine and Cellular Longevity

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Purpose. Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods. This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3–28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results. During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314±0.069 mmol/l versus [vs.] 0.258±0.069 mmol/l, respectively; P=0.002). Similar results were also observed in male and female subgroups (P<0.05). In a multivariable model, a decreased baseline serum UA level was associated with an increased risk for progressing PACG: both in male (hazard ratio [HR] 6.088 [95% confidence interval (CI) 1.163–31.8638]; P=0.032) and female subjects (HR 3.565 [95% CI 1.131–11.236]; P=0.030). Subjects with high UA levels demonstrated higher cumulative probabilities of nonprogressing PACG than those with low UA levels (male [16.67% vs. 80.00%; P=0.0084] and female [29.41% vs. 68.00%; P=0.0182]). Conclusion. An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.

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Baseline Lamina Cribrosa Curvature and Subsequent Visual Field Progression Rate in Primary Open-Angle Glaucoma

Cited by 33 publications

References 33 publications

One year structural and functional glaucoma progression after trabeculectomy

One year structural and functional glaucoma progression after trabeculectomy

Racial Differences in the Association of Anterior Lamina Cribrosa Surface Depth and Glaucoma Severity in the African Descent and Glaucoma Evaluation Study (ADAGES)

Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study

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