Peripapillary and macular vessel density changes after trabeculectomy

Abstract

Aims/Purpose: to evaluate peripapillary, optic disc and macular microvascular changes in glocomatous eyes after trabeculectomy using optical coherence tomography angiography (OCTA).Methods: 90 eyes of 52 patients with primary open angle (20%), pseudoexfoliative (71%) and angle closure glaucoma (9%), and were included. 24 eyes (Group 1) underwent trabeculectomy during the study, 34 eyes (Group 2) had previous trabeculectomy three years more ago and 37 eyes (Group 3) had no trabeculectomy trabeculectomy. The AngioVue OCTA (Optovue Inc., Fremont, CA, USA) was performed at baseline (within one week before trabeculectomy for Group 1), one week and one month following baseline examination. The main outcomes of interest were changes in the superficial and deep macular vessel density (VD) as well as whole image and inside optic disc.Results: The mean IOP at baseline was 25.3 ± 5.0 mmHg, 14.4 ± 3.7 mmHg and 14.7 ± 3.6 mmHg for the Group 1, Group 2 and Group 3 respectively. No significant differences in baseline characteristics were found between three groups, except for Group 3 group had milder glaucoma (it would be good to put the VF MD values of the groups). A reduction of IOP was observed in Group 1 one week and one month after trabeculectomy (14 ± 6.0 mmHg and 10 ± 6.2 mmHg respectively, p < 0.001). There were no significant IOP changes in Group 2 and 3. In all groups the changes in macular vessel density were nonsignificant. In Group 1 the mean inside disc small vessel density increased one week postoperatively (p = 0.04) and peripapillary vessel density increased one month postoperatively(p = 0.03) when compared with the baseline values. There was no significant difference in mean peripapillary or macular vessel densities between groups.Conclusions: IOP reduction causes mild microvascular changes of optic disc and peripapillary regions in early postoperative period, however, does not affect macula.