Retinal perfusion 6 months after trabeculectomy as measured by optical coherence tomography angiography
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To investigate potential changes of vessel density (VD) at the optic nerve head (ONH) and the macula 6 months after trabeculectomy (TE).
In a prospective monocentric study, 19 eyes with open-angle glaucoma were treated with TE + MMC (mitomycin C). At four different time points multiple morphological papillary parameters were measured by OCT, and the ONH VD in the radial peripapillary capillary layer and the superficial and deep plexuses of the macula was determined by OCTA (optical coherence tomography angiography, RTVue-XR, Optovue). The mean defect was determined by visual field examination (mode 30-2, Humphrey Field Analyzer). The duration of follow-up was 6 months.
Nineteen eyes, one each from 19 patients (11 females; 8 males) with a mean age of 66.0 (58.07, 70.94) years and a mean intraocular pressure (IOP) of 21.0 mmHg (17.07, 23.87), were included in the study. All showed a significant reduction in IOP at each follow-up after TE (p < 0.0001). There was no significant change in the peripapillary retinal nerve fiber layer thickness (p = 0.88), the ganglion cell complex (p = 0.97), the cup–disk ratio (p = 0.63), the rim area (p = 0.78), or the mean visual field defect (p = 0.82). With regard to VD, no significant difference could be determined in either the ONH or the macular area.
After significant surgical reduction of IOP by TE, there are no significant detectable morphological changes in the ONH or the ganglion cell complex as measured by OCT, nor does the papillary or macular OCTA-determined VD change significantly.
Trial registration 2016-409-f-S Avanti-OCT-A. Registered December 1, 2016.
KeywordsOCT angiography Glaucoma Intraocular pressure Trabeculectomy Blood flow Vessel density
CL designed the study, collected data, and wrote the manuscript. KR performed all statistical analysis. JMK, CH, and SG assisted in manuscript writing. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
CL: lecture, Optovue
All other authors declare that they have no conflict of interest.
Ethical approval and consent to participate
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research comittee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 14.Xu H, Kong XM (2017) Study of retinal microvascular perfusion alteration and structural damage at macular region in primary open-angle glaucoma patients. Zhonghua Yan Ke Za Zhi Chin J Ophthalmol 53:98–103Google Scholar
- 23.Chihara E, Dimitrova G, Chihara T (2018) Increase in the OCT angiographic peripapillary vessel density by ROCK inhibitor ripasudil instillation: a comparison with brimonidine. Graefes Arch Clin Exp Ophthalmol 256:1257–1264. https://doi.org/10.1007/s00417-018-3945-5 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Hommer A, Sperl P, Resch H et al (2012) A double-masked randomized crossover study comparing the effect of latanoprost/timolol and brimonidine/timolol fixed combination on intraocular pressure and ocular blood flow in patients with primary open-angle glaucoma or ocular hypertension. J Ocul Pharmacol Ther Off J Assoc Ocul Pharmacol Ther 28:569–575. https://doi.org/10.1089/jop.2011.0165 CrossRefGoogle Scholar
- 25.Feke GT, Rhee DJ, Turalba AV, Pasquale LR (2013) Effects of dorzolamide-timolol and brimonidine-timolol on retinal vascular autoregulation and ocular perfusion pressure in primary open angle glaucoma. J Ocul Pharmacol Ther Off J Assoc Ocul Pharmacol Ther 29:639–645. https://doi.org/10.1089/jop.2012.0271 CrossRefGoogle Scholar
- 26.Zéboulon P, Lévêque P-M, Brasnu E et al (2017) Effect of surgical intraocular pressure lowering on peripapillary and macular vessel density in glaucoma patients: an optical coherence tomography angiography study. J Glaucoma 26:466–472. https://doi.org/10.1097/IJG.0000000000000652 CrossRefPubMedGoogle Scholar
- 29.Alnawaiseh M, Müller V, Lahme L et al (2018) Changes in flow density measured using optical coherence tomography angiography after istent insertion in combination with phacoemulsification in patients with open-angle glaucoma. J Ophthalmol 2018:2890357. https://doi.org/10.1155/2018/2890357 CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Venugopal JP, Rao HL, Weinreb RN et al (2018) Repeatability and comparability of peripapillary vessel density measurements of high-density and non-high-density optical coherence tomography angiography scans in normal and glaucoma eyes. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2018-312401 CrossRefPubMedGoogle Scholar