Reversal of Glaucomatous Optic Disc Cupping in Adult Patients

Trabeculectomy and optic nerve head topography

“…The newer technologies of image analysis may improve our ability to detect these subtle changes. Shin et al (17) reported that in 13 eyes with IOP reduction greater than 5 mmHg, 10 (77%) had improvement in at least one optic disc parameter when analyzed by computerized stereophotogrammetry with the Rodenstock nerve head analyzer (Munich, Germany), while only 5 eyes (38%) showed qualitative evidence of optic disc cup reversal with stereo photography. Lesk et al (20) also found that the HRT was more sensitive in detecting changes in disc cupping than was the case with stereo photography.…”

“…This correlation has also been reported by others (17,20), although some have found a less consistent correlation (18,24).…”

“…However, Shin et al (17) reported that the time after IOP reduction did not correlate with changes in the optic disc, and Raitta et al (23) found statistically significant improvement in cup volume and mean cup depth after a mean follow-up of 3.7 months, which remained significant for cup volume at 12.1 months. In the latter study, cup/disc area ratio and mean height contour, which were not significantly changed at the first follow-up, were significantly improved in the later exam.…”

Trabeculectomy and optic nerve head topography

“…The newer technologies of image analysis may improve our ability to detect these subtle changes. Shin et al (17) reported that in 13 eyes with IOP reduction greater than 5 mmHg, 10 (77%) had improvement in at least one optic disc parameter when analyzed by computerized stereophotogrammetry with the Rodenstock nerve head analyzer (Munich, Germany), while only 5 eyes (38%) showed qualitative evidence of optic disc cup reversal with stereo photography. Lesk et al (20) also found that the HRT was more sensitive in detecting changes in disc cupping than was the case with stereo photography.…”

“…This correlation has also been reported by others (17,20), although some have found a less consistent correlation (18,24).…”

“…However, Shin et al (17) reported that the time after IOP reduction did not correlate with changes in the optic disc, and Raitta et al (23) found statistically significant improvement in cup volume and mean cup depth after a mean follow-up of 3.7 months, which remained significant for cup volume at 12.1 months. In the latter study, cup/disc area ratio and mean height contour, which were not significantly changed at the first follow-up, were significantly improved in the later exam.…”

The Acute Morphologic Changes That Occur at the Optic Nerve Head Induced by Medical Reduction of Intraocular Pressure

“…The phenomenon of cupping-reversal after reduction in IOP was first recognized in children 2,3 but has also been reported in adults. [4][5][6][7][8] Changes in optic disc topography identified by scanning laser ophthalmoscopy that represent a reversal of optic disc cupping after trabeculectomy have been documented. [9][10][11][12][13] However, although these studies have demonstrated that technology has reached a level of sensitivity where subtle changes in disc morphology can be reliably detected, the studies can be criticized by the relatively long interval between image acquisition before and after reduction in IOP, making an assessment of factors such as lamina compliance at any one time-point, inaccurate.…”

Marked Cup Reversal Presumably Associated With Scleral Biomechanics in a Case of Adult Glaucoma

“…2,3 This phenomenon is postulated to be due to a reversal of the backward bowing of the lamina cribrosa, swelling of the optic disc, and increased intravascular volume. 2,3 In contrast, recent studies using finite element modeling predict that optic nerve head (ONH) biomechanics strongly depend on scleral biomechanical properties.…”

Trabeculectomy and optic nerve head topography

“…The newer technologies of image analysis may improve our ability to detect these subtle changes. Shin et al (17) reported that in 13 eyes with IOP reduction greater than 5 mmHg, 10 (77%) had improvement in at least one optic disc parameter when analyzed by computerized stereophotogrammetry with the Rodenstock nerve head analyzer (Munich, Germany), while only 5 eyes (38%) showed qualitative evidence of optic disc cup reversal with stereo photography. Lesk et al (20) also found that the HRT was more sensitive in detecting changes in disc cupping than was the case with stereo photography.…”

“…This correlation has also been reported by others (17,20), although some have found a less consistent correlation (18,24).…”

“…However, Shin et al (17) reported that the time after IOP reduction did not correlate with changes in the optic disc, and Raitta et al (23) found statistically significant improvement in cup volume and mean cup depth after a mean follow-up of 3.7 months, which remained significant for cup volume at 12.1 months. In the latter study, cup/disc area ratio and mean height contour, which were not significantly changed at the first follow-up, were significantly improved in the later exam.…”

The Acute Morphologic Changes That Occur at the Optic Nerve Head Induced by Medical Reduction of Intraocular Pressure

“…The phenomenon of cupping-reversal after reduction in IOP was first recognized in children 2,3 but has also been reported in adults. [4][5][6][7][8] Changes in optic disc topography identified by scanning laser ophthalmoscopy that represent a reversal of optic disc cupping after trabeculectomy have been documented. [9][10][11][12][13] However, although these studies have demonstrated that technology has reached a level of sensitivity where subtle changes in disc morphology can be reliably detected, the studies can be criticized by the relatively long interval between image acquisition before and after reduction in IOP, making an assessment of factors such as lamina compliance at any one time-point, inaccurate.…”

Marked Cup Reversal Presumably Associated With Scleral Biomechanics in a Case of Adult Glaucoma

“…2,3 This phenomenon is postulated to be due to a reversal of the backward bowing of the lamina cribrosa, swelling of the optic disc, and increased intravascular volume. 2,3 In contrast, recent studies using finite element modeling predict that optic nerve head (ONH) biomechanics strongly depend on scleral biomechanical properties.…”

Trabeculectomy and optic nerve head topography

“…The newer technologies of image analysis may improve our ability to detect these subtle changes. Shin et al (17) reported that in 13 eyes with IOP reduction greater than 5 mmHg, 10 (77%) had improvement in at least one optic disc parameter when analyzed by computerized stereophotogrammetry with the Rodenstock nerve head analyzer (Munich, Germany), while only 5 eyes (38%) showed qualitative evidence of optic disc cup reversal with stereo photography. Lesk et al (20) also found that the HRT was more sensitive in detecting changes in disc cupping than was the case with stereo photography.…”

“…This correlation has also been reported by others (17,20), although some have found a less consistent correlation (18,24).…”

“…However, Shin et al (17) reported that the time after IOP reduction did not correlate with changes in the optic disc, and Raitta et al (23) found statistically significant improvement in cup volume and mean cup depth after a mean follow-up of 3.7 months, which remained significant for cup volume at 12.1 months. In the latter study, cup/disc area ratio and mean height contour, which were not significantly changed at the first follow-up, were significantly improved in the later exam.…”

The Acute Morphologic Changes That Occur at the Optic Nerve Head Induced by Medical Reduction of Intraocular Pressure

“…The phenomenon of cupping-reversal after reduction in IOP was first recognized in children 2,3 but has also been reported in adults. [4][5][6][7][8] Changes in optic disc topography identified by scanning laser ophthalmoscopy that represent a reversal of optic disc cupping after trabeculectomy have been documented. [9][10][11][12][13] However, although these studies have demonstrated that technology has reached a level of sensitivity where subtle changes in disc morphology can be reliably detected, the studies can be criticized by the relatively long interval between image acquisition before and after reduction in IOP, making an assessment of factors such as lamina compliance at any one time-point, inaccurate.…”

Marked Cup Reversal Presumably Associated With Scleral Biomechanics in a Case of Adult Glaucoma

“…2,3 This phenomenon is postulated to be due to a reversal of the backward bowing of the lamina cribrosa, swelling of the optic disc, and increased intravascular volume. 2,3 In contrast, recent studies using finite element modeling predict that optic nerve head (ONH) biomechanics strongly depend on scleral biomechanical properties.…”