Reversal of Optic Disc Cupping After Glaucoma Surgery, Analysed With a Scanning Laser Tomograph

Lesk, Mark R.; Spaeth, George L.; Azuara‐Blanco, Augusto; Araujo, Silvana V.; Katz, L. Jay; Terebuli, Annette K.; Wilson, Richard P.; Moster, Marlene R.; Schmidt, Courtland

doi:10.1097/00061198-199902001-00022

Cited by 42 publications

(71 citation statements)

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“…The most interesting factor is, however, that very often, despite the recovery of the RNFL thickness following a reduction in IOP, this increased thickness is not matched by an improvement in the automatic visual field perimetric indices. 8,46 Our CDI revealed a significant increase in the RI in the CRA which supplies the surface nerve fibre layer and very few or none in the prelaminar region of the optic nerve. 48,49 These data were significantly correlated with the decrease in thickness in the inferior quadrant of RNFL.…”

Section: Discussionmentioning

confidence: 71%

“…42 These data are, however, much debated since, although they are confirmed by some experimental studies, 43,44 frequently in single sectors, 45 in others no optic nerve modifications related to pressure variations have been found. 46,47 It is still not clear what causes an improvement in the RNFL following a reduction in IOP. One hypothesis explains the increase in RNFL in cases with a reduction in IOP as oedema owing to the sudden reduction in pressure following the filtration operation.…”

Section: Discussionmentioning

confidence: 99%

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Optical coherence tomography, frequency-doubling technology, and colour Doppler imaging in ocular hypertension

Cellini

Bernabini

Carbonelli

et al. 2006

Eye

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Purpose To study in ocular hypertension (OH) the retinal nerve fibre layer (RNFL) with optical coherence tomography (OCT) and the neuronal function with frequency-doubling technology (FDT) to assess which of the two methods was more sensitive in detecting early glaucomatous damage. Furthermore, a colour Doppler imaging (CDI) of the optic nerve was carried out to highlight any correlation with RNFL thickness and FDT abnormality. Materials and methods We enrolled 28 ocular hypertensive patients who underwent OCT of the RNFL and FDT. Moreover, we performed a CDI of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). Results The patients with OH following OCT revealed a significant thinning in the RNFL as compared to the control group only in the inferior quadrant: 122.250714.091 vs 131.750710.729 lm (Po0.045). As regards FDT, there was a significant difference between the two groups only for pattern standard deviation (PSD): 3.87371.488 vs 1.93870.704 dB (Po0.044). In OH and in the control group, CDI resistance index (RI) in the OA was 0.76870.012 vs 0.74570.019 (Po0.022), in the CRA was 0.6670.012 vs 0.64570.019 (Po0.032), and in PCAs was 0.67370.039 vs 0.62270.012 (Po0.037). The OCT had a sensitivity of 83% but only in the inferior RNFL quadrant. The FDT-PSD revealed a sensitivity of 85%. Conclusions Both FDT and OCT detect early glaucomatous damage with a slightly superior sensitivity of FDT vs OCT. The CDI measurements suggest that circulatory abnormalities may have a role in the development of OCT and FDT damage.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography, frequency-doubling technology, and colour Doppler imaging in ocular hypertension

Cellini

Bernabini

Carbonelli

et al. 2006

Eye

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“…There are studies investigating changes in optic disc topography demonstrated by the HRT, [11][12][13][14][15][16][17] and changes in the RNFL thickness by OCT [18][19][20] and GDx 21,22 following reduction in IOP, albeit with conflicting conclusions. The variable results of these studies may be due to other factors such as stage of the disease and age.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown reversal of optic disc cupping that was proportional to the magnitude of IOP reduction [11][12][13][14] and age. 15 However, there are other studies that have shown this reversal was a transient phenomenon, which reverted to baseline values with time. 16 Others have shown no significant change in optic disc topography.…”

Section: Introductionmentioning

confidence: 95%

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

Raghu

Pandav

Kaushik

et al. 2012

Eye

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Purpose To study the change in retinal nerve fibre layer (RNFL) thickness and optic nerve head (ONH) parameters using optical coherence tomography (Stratus OCT 3) after trabeculectomy in adult patients with glaucoma. Methods A total of 17 patients with glaucoma undergoing trabeculectomy were recruited. Average and quadrant RNFL thickness measurements, vertical integrated rim area, horizontal integrated rim width, disc area, cup area, and rim area were measured using Stratus OCT within a week before surgery and at 1 week, 1 and 3 months postoperatively. Main outcome measures were change in RNFL and ONH parameters. Pre-and postoperative values were analysed using the Wilcoxon signed-rank test. Results Intraocular pressure (IOP) reduced from 30.23±9.02 mm Hg preoperatively to 9.52 ±2.42 mm Hg at 1 week, 12.35±4.59 mm Hg at 1 month, and 13.6 ±2.31 mm Hg at 3 months after trabeculectomy. A significant increase in average (P ¼ 0.019) and inferior RNFL (P ¼ 0.038) thickness was observed 1 week after surgery. At 3 months postoperatively, they had reverted to preoperative values. RNFL thickness change had no correlation with IOP change. Mean optic disc cup area decreased from 2.39±0.52 mm 2 preoperatively to 2.14 ± 0.52 mm 2 at 1 week (P ¼ 0.022), 2.22 ± 0.53 mm 2 at 1 month (P ¼ 0.038), and 2.27 ± 0.60 mm 2 at 3 months (P ¼ 0.071). No significant change was found in other ONH parameters. Conclusions Short-term fluctuations were noted in RNFL thickness and ONH postoperatively following glaucoma filtration surgery. RNFL thickness temporarily increased and cup area decreased but the values reverted to normal within 3 months.

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“…These findings are comparable with other studies in which the changes in RNFL height were shown by linear regression model to be pressure dependent. 6,10 In particular, segmental analysis showed a significant change in rim volume in the nasal, inferonasal, superonasal, and superotemporal sectors. 7 These authors have suggested that the improvement is limited to the nasal hemidisc and the adjacent RNFL because this area tends to be least affected by the disease, so nerve fiber bundle compression is not as long-standing as that within the temporal hemidisc.…”

Section: Short-term Changes After Trabeculectomy M Figus Et Almentioning

confidence: 97%

Short-term changes in the optic nerve head and visual field after trabeculectomy

Figus

Lazzeri

Nardi

et al. 2011

Eye

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Aims or Purpose To evaluate short-term changes in optic nerve head topography and visual field induced by surgical reduction of intraocular pressure. Methods A prospective study was performed on 56 eyes of 56 patients with uncontrolled primary open-angle glaucoma despite maximum medical therapy, which underwent trabeculectomy. Optic nerve head evaluations by means of Heidelberg Retina Tomograph, and visual field tests were performed pre-operatively, and at 3 and 6 months after surgery. Differences in intraocular pressure, visual field indices, and Heidelberg Retina Tomograph parameters were evaluated with the t-test for paired data. A linear regression model was calculated to analyze the relationship between intraocular pressure reduction and visual field changes, and optic nerve head changes. Results Mean intraocular pressure decreased from 24.4 ± 5.0 mm Hg to 12.1 ± 3.1 mm Hg (month 3, Po0.001), and 10.6±2.8 mm Hg (month 6, Po0.001) after trabeculectomy. Mean retinal nerve fiber layer thickness (baseline, 0.19±0.034; month 3, 0.24 ± 0.039, P ¼ 0.05; month 6, 0.21 ± 0.037, P ¼ 0.05) showed a statistical significant change compared with baseline values. Conclusions In this 6-months study, a significant increase in retinal nerve fiber layer thickness was detected after glaucoma filtration surgery.

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Reversal of Optic Disc Cupping After Glaucoma Surgery, Analysed With a Scanning Laser Tomograph

Cited by 42 publications

References 0 publications

Optical coherence tomography, frequency-doubling technology, and colour Doppler imaging in ocular hypertension

Optical coherence tomography, frequency-doubling technology, and colour Doppler imaging in ocular hypertension

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

Short-term changes in the optic nerve head and visual field after trabeculectomy

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