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The effect of trabeculectomy surgery on the central visual field in patients with glaucoma using microperimetry and optical coherence tomography.

ABSTRACT: PURPOSE:To determine the functional and structural effects of trabeculectomy surgery on patients with advanced glaucoma and central visual field defects in the early post-operative period. METHODS:Thirty consecutive adult subjects with advanced glaucoma requiring trabeculectomy surgery and an established visual field defect within 10° of fixation underwent microperimetry (MAIA MP-1, CenterVue, Padova, Italy) and optic disc optical coherence tomography (OCT) imaging (Spectralis, Heidelberg Engineering, Germany) pre-operatively, and 1 month and 3 months following trabeculectomy surgery. Main outcome measures were post-trabeculectomy change in mean threshold on microperimetry and nerve fibre layer thickness on OCT. Fellow eyes were used as controls. RESULTS:The mean change in MP average threshold values from pre-operative to post-operative was 0.6?±?1.9?dB for treated eyes and 0.1?±?1.3?dB for control eyes (p?=?0.14) at 1 month and 0.2?±?2.3 and -0.3?±?1.6?dB at 3 months (p?=?0.22). Mean change in global nerve fibre layer thickness was -0.6 and -0.5?µm for operated and control eyes, respectively (p?=?0.83), at 1 month and 0.8 and -0.4?µm at 3 months (p?=?0.88). The kappa agreement for structure-function correlation between OCT and MP was 0.735 (confidence interval 0.59-0.88) (p?

SUBMITTER: Ratnarajan G

PROVIDER: S-EPMC6085388 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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The effect of trabeculectomy surgery on the central visual field in patients with glaucoma using microperimetry and optical coherence tomography.

Ratnarajan Gokulan G Jolly Jasleen K JK Yusuf Imran H IH Salmon John F JF

Eye (London, England) 20180430 8

<h4>Purpose</h4>To determine the functional and structural effects of trabeculectomy surgery on patients with advanced glaucoma and central visual field defects in the early post-operative period.<h4>Methods</h4>Thirty consecutive adult subjects with advanced glaucoma requiring trabeculectomy surgery and an established visual field defect within 10° of fixation underwent microperimetry (MAIA MP-1, CenterVue, Padova, Italy) and optic disc optical coherence tomography (OCT) imaging (Spectralis, He ...[more]

PMID: 29706620

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Project description:BackgroundTrabeculectomy (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.MethodsThis 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.ResultsBCVA 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.ConclusionsLower 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.

Dataset Information

The effect of trabeculectomy surgery on the central visual field in patients with glaucoma using microperimetry and optical coherence tomography.

Publications

The effect of trabeculectomy surgery on the central visual field in patients with glaucoma using microperimetry and optical coherence tomography.

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