Forschung & Innovation
Publikationen
Structural Reversal of Disc Cupping After Trabeculectomy Alters Bruch Membrane Opening-Based Parameters to Assess Neuroretinal Rim
PMU Autor*in
L. M. Heindl
Alle Autor*innen
C. Gietzelt, J. Lemke, F. Schaub, M. M. Hermann, T. S. Dietlein, C. Cursiefen, P. Enders, L. M. Heindl
Fachzeitschrift
AMERICAN JOURNAL OF OPHTHALMOLOGY
Kurzfassung
OBJECTIVE: To assess the impact of trabeculectomy for glaucoma on morphometric neuroretinal parameters of the optic nerve head (ONH) using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Retrospective, interventional case series. METHODS: Participants: Eighty-eight eyes of 88 patients who underwent trabeculectomy with mitomycin C in 2016. INTERVENTION: All patients underwent trabeculectomy in 1 eye (study eye) and had evaluable SD-OCT examinations of the ONH to measure neuroretinal tissue before and at least at 1 of the 3-, 6-, and 12-month follow-up time points after surgery. MAIN OUTCOME MEASURES: Longitudinal change in Bruch membrane opening minimum rim width (BMO-MRW), Bruch membrane opening minimum rim area (BMO-MRA), peripapillary retinal nerve fiber layer (RNFL) thickness, intraocular pressure (IOP), and mean deviation in perimetry. RESULTS: In study eyes, BMO-MRW significantly increased postsurgically comparing baseline and follow-up examinations at 3 months (P = .012), at 6 months (P = .007), and at 1 year (P = .010) after trabeculectomy. The increase in BMO-MRW 6 months after surgery correlated with IOP reduction (r = 0.48; P = .001). BMO-MRA showed an equal increase (P ≤ .034). RNFL thickness remained stable between baseline and follow-up at 3, 6, and 12 months and showed a moderate loss after 18 months (P = .021) of follow-up. CONCLUSIONS: Structural reversal of disc cupping after trabeculectomy markedly influences Bruch membrane opening-based parameters for up to more than 1 year. Improvement in morphometry seems to correlate with the reduction of IOP while visual field function appears not to be influenced. In longitudinal follow-up of glaucoma patients by SD-OCT, evaluation of BMO-based parameters necessitates to reflect bias caused by surgery.
Keywords
Adult Aged Aged, 80 and over Bruch Membrane/diagnostic imaging/*pathology Case-Control Studies Cross-Sectional Studies Female Follow-Up Studies Glaucoma, Open-Angle/physiopathology/*surgery Humans Intraocular Pressure/physiology Male Middle Aged Nerve Fibers/*pathology Optic Disk/diagnostic imaging/*physiopathology Optic Nerve Diseases/*physiopathology Retinal Ganglion Cells/*pathology Retrospective Studies Tomography, Optical Coherence/methods *Trabeculectomy Visual Field Tests Visual Fields/physiology