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

Raghu, N; Pandav, Surinder Singh; Kaushik, Sushmita; Ichhpujani, Parul; Ak, Gupta

doi:10.1038/eye.2012.115

Cited by 37 publications

(42 citation statements)

References 28 publications

(48 reference statements)

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“…Data obtained between the PREOP and the FU1 were excluded from the analysis because the RNFL thickness may increase transiently in the early postoperative period and affect the results of linear regression analyses. 24 The accuracy of the segmentation of the RNFL was reviewed, and segmentation errors were manually corrected. Only images that were considered adequate by both observers were included in the analysis.…”

Section: Measurement Of Spectral-domain Optical Coherence Tomography mentioning

confidence: 99%

Lamina Cribrosa Reversal after Trabeculectomy and the Rate of Progressive Retinal Nerve Fiber Layer Thinning

Lee

Kim

2015

Ophthalmology

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Section: Measurement Of Spectral-domain Optical Coherence Tomography mentioning

confidence: 99%

Lamina Cribrosa Reversal after Trabeculectomy and the Rate of Progressive Retinal Nerve Fiber Layer Thinning

Lee

Kim

2015

Ophthalmology

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“…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 Tomography (HRT) 11,13 , which required a manually drawn contour line and thus was more prone to operator induced variability than the newer spectral-domain OCT.The purpose of the current study was to assess the impact of trabeculectomy and associated IOP lowering on rates of VF and RNFL thickness progression, and secondly to determine factors related to these changes following trabeculectomy.…”

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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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“…Unfortunately, the surgery does not restore any visual field already lost (Lamping et al, 1986). However, some improvements in visual function and structural parameters have been observed (Aydin et al, 2003;Chang et al, 2007;Raghu et al, 2012). Raghu with colleagues noted shortterm fluctuations in RNFL thickness which temporarily increased but the values reverted to normal within three months.…”

Section: Discussionmentioning

confidence: 99%

“…There are several studies that evaluated long-term results after trabeculectomy (Aydin et al, 2003;Chang et al, 2007;Rebolleda et al, 2007). Raghu and colleagues showed that RNFL thickness increases and cup area decreases for a transient period after glaucoma surgery but reverts back to preoperative values within three months (Raghu et al, 2012). Bertrand with co-authors confirmed in retrospective study that progression of visual field changes continues after trabeculectomy, albeit at a slower rate (Bertrand et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Glaucoma Filtration Surgery on Structural and Functional Eye Parameters in a Short-Term Study

Baumane

Ranka

Laganovska

2017

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Glaucoma filtration surgery (trabeculectomy) is an effective glaucoma treatment method that provides significant intraocular pressure (IOP) reduction. Indications for this method are in cases where other forms of therapy, like medicines or lasers, have failed, other forms of therapy are not suitable (compliance or side-effects are a problem), in cases where a target pressure is required to prevent clinically significant disease progression that cannot be reached with topical medications and/or laser and in cases that have such advanced glaucoma and high IOP at presentation that other forms of treatment are unlikely to be successful. The aim of this study was to evaluate the effect of glaucoma surgery on the structural and functional eye parameters at different stages of glaucoma. A total of 96 eyes of 96 patients (only one eye from each patient) with different stages of glaucoma (stages 2 to 4) who were undergoing trabeculectomy were recruited. Quadrant retinal nerve fibre layer RNFL) thickness (33 patients), cup/disc vertical and horizontal ratio (36 patients) and MD of visual fields (27 patients) were analysed up to one week before and 1 month after the successful surgery. The results show that the MD value was slightly improved in 50%, 85.7%, and 71.4% of patients with glaucoma stages 2, 3, and 4, respectively. The mean RNFL of all four optic nerve head quadrants increased slightly after the surgery for patients with glaucoma stage 2; in contrast, a decrease in the mean RNFL values for all four quadrants was observed for patients with glaucoma stage 4. Statistically significant changes in the mean values for the optic nerve horizontal c/d ratio after glaucoma surgery were observed (p = 0.033) in contrast to the vertical c/d values (p = 0.77). In total, improvement of the horizontal and vertical c/d ratio was detected in 61.1% and 55.6% of the glaucoma patients, respectively. Although the observed changes were statistically insignificant, the positive influence of glaucoma surgery on the structural and functional eye parameters was more pronounced in moderate stages than in advanced or severe stages of glaucoma.

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

Cited by 37 publications

References 28 publications

Lamina Cribrosa Reversal after Trabeculectomy and the Rate of Progressive Retinal Nerve Fiber Layer Thinning

Lamina Cribrosa Reversal after Trabeculectomy and the Rate of Progressive Retinal Nerve Fiber Layer Thinning

One year structural and functional glaucoma progression after trabeculectomy

The Effect of Glaucoma Filtration Surgery on Structural and Functional Eye Parameters in a Short-Term Study

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