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Abstract #6352 Published in IGR 3-2
Optic disc changes following trabeculectomy: longitudinal and localisation of change
Kotecha A; Siriwardena D; Fitzke FW; Hitchings RA; Khaw PTBritish Journal of Ophthalmology 2001; 85: 956-961
AIMS: To determine whether there were any changes in the optic disc at two years after trabeculectomy. To determine the factors that most influenced change and whether change was localized to any region of the optic disc. METHODS: Ninety-five patients undergoing routine trabeculectomy as part of the ongoing Moorfields/MRC 5-fluorouracil trial were recruited into the study. Eyes were imaged preoperatively (four (SD 3) weeks) with the Heidelberg retina tomograph (HRT, Heidelberg Engineering), and at three months (SD two weeks), one year (SD one month), and two years (SD one month) after surgery. Parameters investigated for change were rim area, rim volume, and maximum cup depth. The predefined segment analysis available on the HRT analysis software was used to determine segmental change. RESULTS: The images of 70 patients were analyzed. Intraocular pressure (IOP) reduced from 22.25 (SD 3.76 ) mmHg, at the time of preoperative imaging, to 15.27 (SD 4.96) mmHg at three months (14.38 (SD 3.89) mmHg at one year, and 13.80 (SD 3.54) mmHg at two years after trabeculectomy. An increase in rim area and rim volume was present at all time points after surgery, but was only found to be statistically significant at two years after surgery. Maximum depth of cup reduced by month 3 and month 12, but showed a slight increase at two years after surgery, although this was still lower than the preoperative measure. Segmental analysis found a significant change in rim volume in the nasal, inferonasal, superonasal, and superotemporal regions at two years after surgery. No significant regional localization for change was found at any other time point or in any other parameter investigated. CONCLUSIONS: Reversal of disc cupping is present at two years after trabeculectomy. The factor most influencing change is reduction of IOP. Segmental analysis showed that change in rim volume was greatest in the nasal, inferonasal, supernasal and superotemporal regions at two years.
Dr Aachal Kotecha, Glaucoma and Wound Healing Research Unit, Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK. a.kotecha@ucl.ac.uk
Classification:
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.9.1 Laser scanning (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
