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Abstract #106911 Published in IGR 23-3
Optical Coherence Tomography Angiography of the Retinal Circulation Following Trabeculectomy for Glaucoma
Hong JW; Sung KR; Shin JWJournal of Glaucoma 2023; 32: 293-300
PRCIS: Despite successful trabeculectomy, eyes with similar levels of peripapillary and macular vessel densities but with worse preoperative visual field mean deviations, may experience functional and vascular decline after surgery. PURPOSE: To evaluate the retinal microcirculation change after trabeculectomy according to glaucoma severity using optical coherence tomography angiography (OCT-A). METHODS: We enrolled 59 eyes of primary open-angle glaucoma (POAG) patients who underwent trabeculectomy. The eyes were categorized into three groups by preoperative visual field (VF) mean deviation (MD), group 1: MD>-12.0 dB, group 2: MD -12.0~-20.0 dB, and group 3: MD <-20.0 dB. OCT-A was performed preoperatively and 1 year after trabeculectomy. The differences in the radial peripapillary capillary vessel density (pVD) and macular VD between pre- and postoperative assessment were analysed and compared in each group. Factors associated with the VD change after trabeculecomy were determined using linear regression analysis. RESULTS: Mean postoperative IOP and IOP reduction did not differ among three groups after trabeculectomy. Preoperative pVD (37.2 vs. 36.6%, P=1.00) and macular VD (39.0 vs. 38.4%, P=1.00) did not differ between groups 1 and 2. Group 1 and 3 showed no changes in VD parameters after trabeculectomy (all, P>0.05). However, group 2 showed statistically significant decreases in pVD (36.6 vs. 32.9%, P<0.001) and macular VD (38.4 vs. 36.0%, P=0.010) after trabeculectomy. The reduction of pVD was associated with a decrease of IOP (Coefficient (β); 0.14, P=0.032) and VF MD (β; 0.15, P=0.0116) in group 2, respectively. CONCLUSION: Following successful trabeculectomy surgery for uncontrolled glaucoma with similar IOP reduction, glaucoma eyes with advanced visual field loss showed reduced pVD and macular VD measured by OCTA. These findings may be relevant to disease progression.
Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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