Changes in Peripapillary and Macular Vessel Densities and Their Relationship with Visual Field Progression after Trabeculectomy.

Jooyoung Yoon,Joong Won Shin,Kyung Rim Sung

doi:10.3390/jcm10245862

Jooyoung Yoon, Joong Won Shin + Show 1 more

Open Access

https://doi.org/10.3390/jcm10245862

Copy DOI

Abstract

The aim of this study was to determine the factors associated with visual field (VF) deterioration after trabeculectomy, including the peripapillary vessel density (pVD) and macular vessel density (mVD) changes assessed by optical coherence tomography angiography (OCT-A). Primary open-angle glaucoma patients with more than two years of follow-up after trabeculectomy were included. pVD was calculated in a region defined as a 750 μm-wide elliptical annulus extending from the optic disc boundary. mVD was calculated in the parafoveal (1–3 mm) and perifoveal (3–6 mm) regions. VF deterioration was defined as the rate of mean deviation (MD) worse than −1.5 dB/year. The change rates of pVD and mVD were compared between the deteriorated VF and non-deteriorated VF groups. The factors associated with the rate of MD were determined by linear regression analyses. VF deterioration was noted in 14 (21.5%) of the 65 eyes that underwent trabeculectomy. The pVD (−2.26 ± 2.67 vs. −0.02 ± 1.74%/year, p ≤ 0.001) reduction rate was significantly greater in the deteriorated VF group than in the non-deteriorated VF group, while that of parafoveal (p = 0.267) and perifoveal (p = 0.350) VD did not show a significant difference. The linear regression analysis showed that the postoperative MD reduction rate was significantly associated with the rate of pVD reduction (p = 0.016), while other clinical parameters and preoperative vascular parameters did not show any association. Eyes with greater loss of peripapillary retinal circulation after trabeculectomy tended to exhibit VF deterioration. The assessment of peripapillary vascular status can be an adjunctive strategy to predict visual function after trabeculectomy.

Highlights

Glaucoma causes progressive structural abnormalities in the optic nerve head (ONH)and the loss of visual function [1]
The baseline characteristics are described in mean deviation (MD), and intraocular pressure (IOP) did not differ between the two groups
Our study demonstrated a two-year visual field (VF) change after trabeculectomy in primary open-angle glaucoma (POAG) eyes and the factors associated with the postoperative VF deterioration

Summary

Introduction

Glaucoma causes progressive structural abnormalities in the optic nerve head (ONH)and the loss of visual function [1]. Glaucoma causes progressive structural abnormalities in the optic nerve head (ONH). The mainstay of glaucoma treatment is slowing down the disease progression by preventing further ONH damage. The lowering of intraocular pressure (IOP) is the only proven way to slow down the disease progression [2,3]. Previous studies have evaluated the changes of the ocular hemodynamic in the ophthalmic artery, ONH, and retinal vasculature [9,10] after medical or surgical IOP reduction. OCT-A allows the precise visualization of the retinal capillary network [12] layer by layer, and a reduction of the vessel density (VD) assessed by OCT-A showed a correlation with the structural and functional parameters in glaucoma patients [13,14,15]

Objectives

Methods

Results

Discussion

Conclusion