Evaluation of Papillomacular Nerve Fiber Bundle Thickness in Glaucoma Patients with Visual Acuity Disturbance

Takahashi, Nana; Omodaka, Kazuko; Pak, Kyongsun; Kikawa, Tsutomu; Kobayashi, Wataru; Nakazawa, Toru

doi:10.1080/02713683.2019.1703006

Cited by 7 publications

(10 citation statements)

References 20 publications

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“…Previously, we developed an original scan pattern and showed its usefulness for the evaluation of visual function in glaucoma patients [ 23 , 24 ]. Recently, we also confirmed the specific area of the PMB that is related to BCVA changes in the advanced stage of glaucoma [ 25 , 26 ]. We sometimes observe a discrepancy between structure and function in glaucoma patients when they are young.…”

Section: Introductionsupporting

confidence: 64%

“…We previously reported that in myopic glaucoma, peripapillary choroidal microvasculature dropout and impaired BF in the adjacent temporal ONH-tissue contributed to PMB thinning and central visual field defects [ 32 , 41 ] which is consistent with the current findings. In this study, preoperative PMB thickness in the BCVA-decline group was already below the cut-off value of 88.6 μm that we reported for BCVA loss [ 25 ], indicating that there was no redundancy in neuron fibers. The ischemia-reperfusion cycle that is usually tolerable during trab might thus have led to the irreversible BCVA decline we observed in this study, as these eyes were already in a damaged neuronal state.…”

Section: Discussionmentioning

confidence: 41%

“…The inclusion criteria were (1) a diagnosis of OAG, including either primary open-angle glaucoma (POAG), NTG, or pseudo-exfoliation (PE) glaucoma, and (2) a glaucomatous visual field defect, meeting the Anderson-Patella classification, i.e., with one or more of the following: (a) a cluster of three points with a probability of < 5% on the pattern deviation map in at least one hemifield (including ≥ 1 point with probability of < 1% or a cluster of two points with a probability of < 1%, (b) glaucomatous hemifield test results outside the normal limits, and (c) a pattern standard deviation beyond 95% of normal limits, as confirmed in at least two reliable examinations. The exclusion criteria were (1) age younger than 20 years, (2) preoperative decimal BCVA less than 0.7, (3) axial length ≥ 28.0 mm [ 25 , 29 , 30 ], and (4) the presence of other ocular diseases or systemic diseases affecting the visual field. Previous studies have used two lines of loss, or an equivalent change in logMAR, in advanced glaucoma patients who underwent trab [ 15 , 17 , 31 ].…”

Section: Methodsmentioning

confidence: 99%

“…Total circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and cpRNFLT in the quadrants (superior, nasal, inferior, and temporal) were used for the analysis. The evaluation of the PMB was performed as previously described [ 25 ]. Briefly, we used wide scans (12 × 9 mm) and selected a central vertical B-scan (1.5 × 9 mm) that ran through the midpoint of the disc-fovea line, which was automatically detected by the program included in the accompanying software.…”

Section: Methodsmentioning

confidence: 99%

“…This central strip can be considered less susceptible to the effects of the peripapillary chorioretinal atrophy zone than the ONH. All OCT scans with image quality less than 40 were excluded [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

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Predictive potential of optical coherence tomography parameters for the prognosis of decreased visual acuity after trabeculectomy in open-angle glaucoma patients with good vision

Takeda,

Takahashi,

Kiyota

et al. 2023

BMC Ophthalmol

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Background Trabeculectomy (trab) is the most effective surgical procedure for lowering IOP and preventing glaucoma progression. However, decline in best-corrected visual acuity (BCVA) is one of the most serious postoperative complications of trab. Here, we investigated methods to predict decreased BCVA after trab in glaucoma patients with good preoperative BCVA. Methods This study included 35 eyes of 35 open-angle glaucoma (OAG) patients (male / female: 21 / 14, age: 64.0 ± 9.7 years old, preoperative intraocular pressure: 15.9 ± 5.4 mmHg, mean deviation: -18.1 ± 5.6 dB) with preoperative BCVA of 0.7 or better who underwent trab and were observed for more than 12 months. As a preoperative analysis, we measured temporal quadrant circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and ganglion cell complex thickness in a central strip between the disc and fovea (csGCCT), an area that corresponds to the location of the papillomacular bundle (PMB) in swept-source optical coherence tomography (OCT). We defined BCVA decline as a loss of more than 3 lines of BCVA after 12 months. Measurement parameters were compared between the BCVA-decline group and the non-BCVA-decline group. Results BCVA decline was detected in 11 cases (31.4%) 12 months after trab. There was a statistically significant difference in axial length (P = 0.049). A single logistic analysis showed that the BCVA-decline group had significantly lower cpRNFLT than the non-BCVA-decline group (27.7 ± 8.0 μm vs. 45.1 ± 5.3 μm, P < 0.001, cut-off value: 33.4 μm), as well as lower csGCCT (72.4 ± 7.7 μm vs. 87.5 ± 5.1 μm, P = 0.002, cut-off value: 82.3 μm). Multivariable logistic analysis showed that the BCVA-decline group had significantly lower temporal quadrant cpRNFLT (P < 0.001) and lower middle csGCCT (P < 0.001) compared to the non-BCVA-decline group. Conclusions Lower temporal quadrant cpRNFLT and middle csGCCT, OCT scan areas that correspond to the location of the PMB, might be biomarkers that predict BCVA decline after trab in OAG patients with good vision.

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