PMID- 34113077
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 1177-5467 (Print)
IS  - 1177-5483 (Electronic)
IS  - 1177-5467 (Linking)
VI  - 15
DP  - 2021
TI  - Changes of Neuroretinal Rim and Retinal Nerve Fiber Layer Thickness Assessed by 
      Optical Coherence Tomography After Filtration Surgery in Glaucomatous Eyes.
PG  - 2335-2344
LID - 10.2147/OPTH.S298045 [doi]
AB  - PURPOSE: Lowering the intraocular pressure (IOP) in patients with primary 
      open-angle glaucoma (POAG) with filtration surgery can induce morphological 
      changes to the bulbus and structures of the retina. In this study, we have 
      evaluated changes of Bruch's membrane-based parameters and retinal nerve fiber 
      layer (RNFL) derived by spectral-domain optical coherence tomography (SD-OCT) in 
      eyes that have undergone glaucoma filtration surgery. PATIENTS AND METHODS: 
      SD-OCT imaging of the optic nerve head (ONH) and of the RNFL was performed in 54 
      eyes of 54 patients with medically uncontrolled POAG before and after 
      IOP-lowering surgery (trabeculectomy or deep sclerectomy). The ONH parameter 
      minimum rim width (MRW) and the size of the Bruch's membrane opening (BMO-Area) 
      were derived from 24 radial B-scans centered on the ONH. RESULTS: The average 
      preoperative IOP was 23.1 +/- 7.5 mmHg. One month postoperatively, the average IOP 
      decreased to 12.1 +/- 4.6 mmHg (p < 0.01), which caused a significant increase in 
      the thickness of neuroretinal rim. There was no significant change in the 
      automatically detected BMO-Area (p = 0.32). The pressure-related increase in MRW 
      correlated well with the postoperative IOP and cup-to-disc ratio (CDR). In 
      regression analysis, the alteration in thickness of the neuroretinal rim could be 
      well predicted in a model including CDR, change of IOP and mean deviation (MD) 
      (R(2) = 0.414, p < 0.001). RNFL showed a significant increase as well. 
      CONCLUSION: IOP-lowering surgery in patients with medically uncontrolled POAG 
      causes an increased thickness of the SD-OCT derived ONH parameters. The changes 
      of the RNFL after surgery showed no significant correlations with IOP changes. In 
      contrast to this, highly significant correlations of MRW values with the IOP 
      could be observed. The BMO-Area remained completely stable A preferred use of 
      RNFL for follow-up should be discussed.
CI  - (c) 2021 Koenig and Hirneiss.
FAU - Koenig, Susanna Friederike
AU  - Koenig SF
AD  - Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
FAU - Hirneiss, Christoph Wolfgang
AU  - Hirneiss CW
AD  - Ludwig-Maximilians University, Eye Clinic, Campus Innenstadt, Munich, D-80336, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20210603
PL  - New Zealand
TA  - Clin Ophthalmol
JT  - Clinical ophthalmology (Auckland, N.Z.)
JID - 101321512
PMC - PMC8184240
OTO - NOTNLM
OT  - BMO
OT  - Bruch's membrane opening
OT  - OCT
OT  - ONH
OT  - RNFL
OT  - glaucoma
OT  - optic nerve head
OT  - retinal nerve fiber layer
COIS- The authors report no conflicts of interest in this work.
EDAT- 2021/06/12 06:00
MHDA- 2021/06/12 06:01
PMCR- 2021/06/03
CRDT- 2021/06/11 06:40
PHST- 2020/12/22 00:00 [received]
PHST- 2021/03/15 00:00 [accepted]
PHST- 2021/06/11 06:40 [entrez]
PHST- 2021/06/12 06:00 [pubmed]
PHST- 2021/06/12 06:01 [medline]
PHST- 2021/06/03 00:00 [pmc-release]
AID - 298045 [pii]
AID - 10.2147/OPTH.S298045 [doi]
PST - epublish
SO  - Clin Ophthalmol. 2021 Jun 3;15:2335-2344. doi: 10.2147/OPTH.S298045. eCollection 
      2021.