Changes in choroidal thickness following trabeculectomy and its correlation with the decline in intraocular pressure

  • Diana Silva
  • Ana Sofia Lopes
  • Susana Henriques
  • Maria Lisboa
  • Sara Pinto
  • Fernando Trancoso Vaz
  • Isabel Prieto
Original Paper



Evaluate whether there are significant changes in choroidal thickness following trabeculectomy, and how they relate do the decline in intraocular pressure.


This was a prospective evaluation of 28 eyes who underwent Moorfields modified trabeculectomy. The choroidal thickness was measured via OCT with enhanced depth imaging, before surgery and 1 day, 1 week and 1 month after surgery. Measurements were taken at the fovea, 1000 µm temporal to the fovea and 1000 µm nasal to the fovea. The relationship between choroidal thickness and intraocular pressure was statistically evaluated.


The mean intraocular pressure before surgery was 25.07 ± 4.64 mmHg; 8.57 ± 3.62 mmHg after 1 day; 10.36 ± 4.39 mmHg after 1 week and 13.71 ± 5.13 mmHg after 1 month. Mean choroidal thickness increased after trabeculectomy with maximal values at 1 week. The largest increase was found at the fovea, with an average before surgery of 253.54 ± 62.01 µm; 286.75 ± 64.20 µm at 1 day, 286.36 ± 63.14 µm at 1 week and 271.00 ± 60.31 µm at 1 month. Increase in choroidal thickness was significant 1 day and 1 week after surgery in the foveal (p = 0.012, p = 0.007) and temporal (p = 0.040, p = 0.000) locations and 1 week postoperatively on the nasal location (p = 0.016). None of them were significant at 1 month after surgery. Preoperative IOP and choroidal thickness were correlated at all macular locations (ρ = 0.449–0.525, p = 0.004–0.016) yet no correlation was found between increase in choroidal thickness and decline in intraocular pressure in the postoperative period.


Choroidal thickness appears to increase temporarily after trabeculectomy and these changes were not correlated with the decline in intraocular pressure. Further research is required to fully understand this phenomenon.


Choroidal thickness Glaucoma Intraocular pressure Optical coherence tomography Trabeculectomy 



This study has not received any funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Pederson JE (1984) Hypotony. In: Duane TD (ed) Clinical ophthalmology, chapter 58, vol 3. Harper & Row, Philadelphia, pp 1–8Google Scholar
  2. 2.
    Stamper RL, McMenemy MG, Lieberman MF (1992) Hyptonous maculopathy after trabeculectomy with subconjunctival 5-fluorouracil. Am J Ophthalmol 114:544–553CrossRefPubMedGoogle Scholar
  3. 3.
    Suner IJ, Greenfield DS, Miller MP, Nicolela MT, Palmberg PF (1997) Hypotony maculopathy after filtering surgery with mitomycin C. Incidence and treatment. Ophthalmology 104:207–214CrossRefPubMedGoogle Scholar
  4. 4.
    Cashwell LF, Martin CA (1999) Axial length decrease accompanying successful glaucoma filtration surgery. Ophthalmology 106:2307–2311CrossRefPubMedGoogle Scholar
  5. 5.
    Berisha F, Schmetterer K, Vass C, Dallinger S, Rainer G, Findl O et al (2005) Effect of trabeculectomy on ocular blood flow. Br J Ophthalmol 89:185–188CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Margolis R, Spaide RF (2009) A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 147:811–815CrossRefPubMedGoogle Scholar
  7. 7.
    Spaide RF, Koizumi H, Pozzoni MC (2008) Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 146:496–500CrossRefPubMedGoogle Scholar
  8. 8.
    Kara N, Baz O, Altan C, Satana B, Kurt T, Demirok A (2013) Changes in choroidal thickness, axial length, and ocular perfusion pressure accompanying successful glaucoma filtration surgery. Eye 27(8):940–945CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Usui S, Ikuno Y, Uematsu S, Morimoto Y, Yasuno Y, Otori Y (2013) Changes in axial length and choroidal thickness after intraocular pressure reduction resulting from trabeculectomy. Clin Ophthalmol 7:1155–1161CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Saeedi O, Pillar A, Jefferys J, Arora K, Friedman D, Quigley H (2014) Change in choroidal thickness and axial length with change in intraocular pressure after trabeculectomy. Br J Ophthalmol 98(7):976–979CrossRefPubMedGoogle Scholar
  11. 11.
    Chen S, Wang W, Gao X, Li Z, Huang W, Li X, Zhou M, Zhang X (2014) Changes in choroidal thickness after trabeculectomy in primary angle closure glaucoma. Investig Ophthalmol Vis Sci 55(4):2608–2613CrossRefGoogle Scholar
  12. 12.
    Esmaeelpour M, Povazay B, Hermann B, Hofer B, Kajic V, Kapoor K et al (2010) Three-dimensional 1060-nm OCT: choroidal thickness maps in normal subjects and improved posterior segment visualization in cataract patients. Investig Ophthalmol Vis Sci 51:5260–5266CrossRefGoogle Scholar
  13. 13.
    Fujiwara T, Imamura Y, Margolis R, Slakter JS, Spaide RF (2009) Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes. Am J Ophthalmol 148:445–450CrossRefPubMedGoogle Scholar
  14. 14.
    Ikuno Y, Tano Y (2009) Retinal and choroidal biometry in highly myopic eyes with spectral-domain optical coherence tomography. Investig Ophthalmol Vis Sci 50:3876–3880CrossRefGoogle Scholar
  15. 15.
    Mwanza JC, Hochberg JT, Banitt MR, Feuer WJ, Budenz DL (2011) Lack of association between glaucoma and macular choroidal thickness measured with enhanced depth-imaging optical coherence tomography. Investig Ophthalmol Vis Sci 52:3430–3435CrossRefGoogle Scholar
  16. 16.
    Ikuno Y, Kawaguchi K, Nouchi T, Yasuno Y (2010) Choroidal thickness in healthy Japanese subjects. Investig Ophthalmol Vis Sci 51:2173–2176CrossRefGoogle Scholar
  17. 17.
    Nickla DL, Wallman J (2010) The multifunctional choroid. Prog Retin Eye Res 29:144–168CrossRefPubMedGoogle Scholar
  18. 18.
    Rahman W, Chen FK, Yeoh J, Patel P, Tufail A, Da Cruz L (2011) Repeatability of manual subfoveal choroidal thickness measurements in healthy subjects using the technique of enhanced depth imaging optical coherence tomography. Investig Ophthalmol Vis Sci 52(5):2267–2271CrossRefGoogle Scholar
  19. 19.
    Karaca EE, Özdek Ş, Yalçin NG, Ekici F (2014) Reproducibility of choroidal thickness measurements in healthy Turkish subjects. Eur J Ophthalmol 24(2):202–208CrossRefPubMedGoogle Scholar
  20. 20.
    Wong IY, Wong RL, Zhao P, Lai WW (2013) Choroidal thickness in relation to hypercholesterolemia on enhanced depth imaging optical coherence tomography. Retina 33(2):423–428CrossRefPubMedGoogle Scholar
  21. 21.
    Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S (2016) Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 26(2):152–157CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital Professor Doutor Fernando da Fonseca EPE (Amadora-Sintra)LisbonPortugal

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