Topographic optic disc changes after successful trabeculectomy evaluated using spectral domain optical coherence tomography

J Ocul Pharmacol Ther. 2013 Dec;29(10):870-5. doi: 10.1089/jop.2013.0127. Epub 2013 Sep 26.

Abstract

Purpose: To investigate topographic optic disc changes after surgical intraocular pressure (IOP) reduction in adults with open angle glaucoma (OAG).

Methods: Optic discs of patients with advanced primary open angle or exfoliation glaucoma were imaged using optical coherence tomography within 1 week before trabeculectomy. Patients were rescanned 1 week, 1 month, and 1 year after surgery. Maximum cup depth (MCD), and average cup depth (ACD) were calculated.

Results: Twenty-two eyes from 20 patients (age, 70.5 ± 10.6 years; average mean defect of visual field, -15.0 ± 9.8 dB) were followed up for 1 year. The IOP decreased from 22.1 ± 2.8 mmHg at baseline to 11.5±2.6 mmHg 1 year following surgery (P<0.001). One-week and 1-month postoperative IOPs were 11.2 ± 2.8 and 11.2 ± 3.5 mmHg, respectively (P<0.001). Compared to the baseline values (356 ± 172 μm), postoperative ACD showed a significant decrease at 1 week (312 ± 164 μm; P<0.001) and 1 month (338 ± 175 μm; P=0.007) after surgery, but not at 1 year (339 ± 176 μm; P=0.354). Similarly, MCD significantly decreased from baseline (477 ± 190 μm) 1 week (431 ± 203 μm; P=0.029) and 1 month (448 ± 198 μm; P=0.047) after the surgery, but not after 1 year (479 ± 188 μm; P=1.0).

Conclusions: Trabeculectomy reduces IOP in eyes with advanced OAG, which induces topographic optic disc changes. Such optic disc changes became less pronounced over time and were no longer detectable 1 year after surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Exfoliation Syndrome / surgery*
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Optic Disk / pathology*
  • Time Factors
  • Tomography, Optical Coherence
  • Trabeculectomy*
  • Visual Fields