Changes in choroidal thickness and optic nerve head morphology after filtering surgery: nonpenetrating deep sclerectomy versus trabeculectomy

Abstract

BackgroundThe purpose of this study was to evaluate the changes in choroidal thickness and lamina cribrosa position after nonpenetrating deep sclerectomy (NPDS) and trabeculectomy.MethodsTwenty-three eyes with glaucoma that required filtering surgery were included (12 NDPS and 11 trabeculectomies) in this prospective observational study. OCT-enhanced depth imaging (OCT-EDI) was used to measure choroidal thickness, prelaminar tissue thickness and lamina cribrosa position before and 7 days and 1 month after surgery. All results are shown as median (interquartile range values).ResultsIntraocular pressure (IOP) was significantly lower 1 week after surgery than at baseline (7 (6/10) mmHg vs. 21 (18/26) mmHg; p < 0.001) with a mean 64% decrease. IOP remained significantly lower at 1 month with a 55% mean decrease as compared to baseline (10 (8/12) mmHg; p < 0.001). One week after surgery, the subfoveolar choroidal thickness (SFCT) significantly increased (372 (306/523) μm vs. 317 (227/413) μm; p = 0.04) and the prelaminar tissue (PLT) was significantly thicker (269 (162/360) μm vs. 138 (87/268) μm; p = 0.02) as compared to preoperative measurements. These changes were not statistically significant at one month. There were no differences concerning these parameters between the NPDS and trabeculectomy groups. During the first week, the SFCT increase was correlated with IOP reduction (r = − 0.41; p = 0.04).ConclusionsOCT-EDI allowed the visualization of structural changes at the level of the optic nerve and choroidal vascularization during acute IOP changes. No difference was observed between NPDS and trabeculectomy concerning these structural modifications.

Early evaluation of optic nerve head morphology and choroidal thickness after PreserFlo MicroShunt implantation

“…In accordance with previous studies performed on trabeculectomy, we found a significant increase in CT both in macula and in peripapillary region after the decline of the IOP, already 24 h after surgery [ 3 , 7 – 10 ].…”

“…In our study, the magnitude of morphological changes in the choroid and laminar region did not appear to be correlated with the IOP reduction magnitude or the baseline IOP value. Conversely, Buillot et al found a correlation between IOP variation linked to the MicroShunt and changes in macular choroidal thickness one week after surgery [ 7 ].…”

“…To the best of our knowledge, the changes in choroidal thickness and in optic nerve head morphology following PreserFlo MicroShunt implantation have not been investigated yet. Moreover, previous reports of choroidal thickness and optic nerve head morphology changes, reported data from 7 days to 6 months after glaucoma surgery [ 3 , 7 ]. The present study aims to investigate the earliest alteration of choroidal and optic nerve head structure analyzing EDI-OCT images acquired 24 h after surgery.…”

Effect of SCUBA Diving on Ophthalmic Parameters

“…In the literature, SFCT tends to be negatively correlated to IOP [ 33 , 34 , 35 , 36 , 37 , 38 ]. As both IOP and SFCT decrease in our study, IOP variation does not explain the SFCT decreases.…”