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Abstract #108435 Published in IGR 23-4
Change of Choroidal Microvasculature Dropout After Trabeculectomy as Assessed by Optical Coherence Tomography Angiography
Baek MS; Sung KR; Shin JW; Lee JY; Kim KEJournal of Glaucoma 2023; 32: 665-672
PURPOSE: To investigate change of choroidal microvasculature dropout (CMvD) after trabeculectomy and its associated factors in primary open-angle glaucoma (POAG) eyes using optical coherence tomography angiography (OCTA). METHODS: Fifty eyes of 50 POAG participants who had preoperative CMvD and underwent trabeculectomy were prospectively enrolled. Angular circumference (AC) of CMvD was determined from choroidal-layer images by OCTA preoperatively and at postoperative 1 year. The cutoff for significant angular circumference of choroidal microvascular dropout (CMvD AC) decrease was determined by the Bland-Altman method, and accordingly, patients were divided into two, decreased and stable/increased CMvD AC groups. Changes in intraocular pressure (IOP) and CMvD AC were compared between the groups preoperatively and at postoperative 1 year. Factors associated with CMvD AC decrease were assessed by linear regression analysis. RESULTS: The cutoff for significant CMvD AC decrease was 3.58°; accordingly, 26 eyes (52.0%) were categorized as decreased CMvD AC group. No significant intergroup differences in baseline characteristics were found. However, the decreased CMvD AC group presented significantly lower IOP (10.7±3.7 vs. 12.9±2.6 mmHg, P=0.022), lower CMvD AC (32.03±33.95 vs. 53.44±39.33%, P=0.044), and higher parapapillary choroidal vessel density (P=0.014) compared with the increased/stable CMvD AC group at postoperative 1 year. The greater percentage of IOP reduction was significantly associated with decreased CMvD AC (P=0.046). CONCLUSIONS: CMvD AC reduction associated with IOP lowering was found after trabeculectomy. The long-term clinical relevance of postoperative CMvD reduction should be further investigated.
Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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