Improved retinal function after trabeculectomy in glaucoma patients

Wittström, Elisabeth; Schatz, Patrik; Lövestam-Adrian, Monica; Ponjavic, Vesna; Bergström, Anders; Andréasson, Sten

doi:10.1007/s00417-009-1220-5

Cited by 15 publications

(9 citation statements)

References 54 publications

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“…If these findings are confirmed in larger studies, clinicians and researchers alike may be using OCTA to detect sick, poorly functioning retinal ganglion cells that may benefit from either aggressive IOP-lowering treatments or neuroprotective treatments. While pronounced IOP-lowering surgery has already been shown to reverse visual field damage, presumably salvaging sick retinal ganglion cells before apoptosis (Pederson and Herschler 1982, Tsai, Shin et al 1991, Gandolfi 1995, Wittstrom, Schatz et al 2010, Caprioli, de Leon et al 2016, Waisbourd, Ahmed et al 2016), OCTA may provide the tool needed to identify patients with salvageable retinal ganglion cells.…”

Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

741

561

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OCT has revolutionized the practice of ophthalmology over the past 10 to 20 years. Advances in OCT technology have allowed for the creation of novel OCT-based methods. OCT-Angiography (OCTA) is one such method that has rapidly gained clinical acceptance since it was approved by the FDA in late 2016. OCTA images are based on the variable backscattering of light from the vascular and neurosensory tissue in the retina. Since the intensity and phase of backscattered light from retinal tissue varies based on the intrinsic movement of the tissue (e.g. red blood cells are moving, but neurosensory tissue is static), OCTA images are essentially motion-contrast images. This motion-contrast imaging provides reliable, high resolution, and non-invasive images of the retinal vasculature in an efficient manner. In many cases, these images are approaching histology level resolution. This unprecedented resolution coupled with the simple, fast and non-invasive imaging platform have allowed a host of basic and clinical research applications. OCTA has been shown to demonstrate many important clinical findings including areas of macular telangiectasia, impaired perfusion, microaneurysms, capillary remodeling, some types of intraretinal fluid, and neovascularization among many others. More importantly, OCTA provides depth-resolved information that has never before been available. Correspondingly, OCTA has been used to evaluate a spectrum of retinal vascular diseases including diabetic retinopathy (DR), retinal venous occlusion (RVO), uveitis, retinal arterial occlusion, and age-related macular degeneration among others. In this review, we will discuss the methods used to create OCTA images, the practical applications of OCTA in light of invasive dye-imaging studies (e.g. fluorescein angiography) and review clinical studies demonstrating the utility of OCTA for research and clinical practice.

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Section: Review Of Clinical Studies Utilizing Octamentioning

confidence: 99%

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Kashani

Chen

Gahm

et al. 2017

Progress in Retinal and Eye Research

741

561

View full text Add to dashboard Cite

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“…They suggest that the observed improvement of PERGLA amplitude is consistent with IOP-dependent reversible RGC dysfunction. Wittström et al (Wittstrom, et al, 2010) showed improvement in multifocal ERG among 11 glaucomatous eyes after trabeculectomy. In a prospective study of 47 eyes that underwent surgical IOP reduction for uncontrolled IOP, Sehi et al (Sehi, et al, In press) recently reported that the mean postoperative PERGLA amplitude (0.46±0.22 μV) significantly increased compared to preoperative PERGLA amplitude (0.37±0.18 μV).…”

Section: Discussionmentioning

confidence: 99%

The impact of intraocular pressure reduction on retinal ganglion cell function measured using pattern electroretinogram in eyes receiving latanoprost 0.005% versus placebo

et al. 2011

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Purpose To evaluate the impact of intraocular (IOP) reduction on retinal ganglion cell (RGC) function measured using pattern electroretinogram optimized for glaucoma (PERGLA) in glaucoma suspect and glaucomatous eyes receiving latanoprost 0.005% versus placebo. Methods This was a prospective, placebo-controlled, double masked, crossover clinical trial. One randomly selected eye of each subject meeting eligibility criteria was enrolled. At each visit, subjects underwent five diurnal measurements between 8:00 am and 4:00 pm consisting of Goldmann IOP, and PERGLA measurements. A baseline examination was performed following a four-week washout period, and repeat examination after randomly receiving latanoprost or placebo for four-weeks. Subjects were then crossed over to receive the alternative therapy for four weeks following a second washout period, and underwent repeat examination. Linear mixed-effect models were used for the analysis. Results Sixty-eight eyes (35 glaucoma, 33 glaucoma suspect) of 68 patients (mean age 67.4 ±10.6 years) were enrolled. The mean IOP (mmHg) after latanoprost 0.005% therapy (14.9±3.8) was significantly lower than baseline (18.8±4.7, p<0.001) or placebo (18.0±4.3), with a mean reduction of −20 ± 13%. Mean PERGLA amplitude (μv) and phase (π-radian) using latanoprost (0.49 ± 0.22 and 1.71 ± 0.22, respectively) were similar (p>0.05) to baseline (0.49±0.24 and 1.69±0.19) and placebo (0.50±0.24 and 1.72±0.23). No significant (p>0.05) diurnal variation in PERGLA amplitude was observed at baseline, or using latanoprost or placebo. Treatment with latanoprost, time of day, and IOP were not significantly (p>0.05) associated with PERGLA amplitude or phase. Conclusion Twenty percent IOP reduction using latanoprost monotherapy is not associated with improvement in RGC function measured with PERGLA.

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“…Wittstrom et al . [11] reported that a significant lowering of IOP seemed to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with multi-focal electroretinography.…”

Section: Discussionmentioning

confidence: 99%

Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report

et al. 2011

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IntroductionWe report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision.Case presentationA 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye). He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication.ConclusionFunctional vision can be regained despite long-standing retinal detachment.

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Improved retinal function after trabeculectomy in glaucoma patients

Abstract: A significant lowering of IOP seems to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with mfERG.

Cited by 15 publications

References 54 publications

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications

The impact of intraocular pressure reduction on retinal ganglion cell function measured using pattern electroretinogram in eyes receiving latanoprost 0.005% versus placebo

Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report

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