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Abstract #86575 Published in IGR 21-2
Evaluation of Long-Term Visual Field Function in Patients Undergoing Glaucoma Drainage Device Implantation
Liu Q; Saifee M; Yu Y; Ying GS; Li S; Zhong H; Gedde SJ; Han YAmerican Journal of Ophthalmology 2020; 216: 44-54
PURPOSE: To determine the change in global and regional Humphrey visual fields (VF) after glaucoma drainage device (GDD) implantation over a 3-year follow-up period. DESIGN: Retrospective interventional case series. METHODS: Patients undergoing GDD placement from between 2010 and 2015 with reliable preoperative and yearly postoperative VF measurements were included. Clinical parameters were compared between preoperative and follow-up visits, including visual acuity, intraocular pressure (IOP), number of glaucoma medications, global VF metrics (mean deviation [MD]), pattern standard deviation (PSD), CIGTS (Collaborative Initial Glaucoma Treatment Study) score of total deviation probability (CIGTS_TDP) and pattern deviation probability (CIGTS_PDP), and regional metrics (regional total deviation (TD), regional pattern deviation (PD), and regional CIGTS_TDP and CIGTS_PDP). Multivariate regression analyses were performed to determine risk factors for VF worsening after GDD surgery. RESULTS: A total of 106 eyes from 95 patients were included. Mean IOP ± SD was reduced from 23.1 ± 8.5 mm Hg to 12.7 ± 3.1 mm Hg at 3-year follow-up (P < .001). MD, PSD, and global CIGTS_PDP showed no significant changes in follow-up, whereas global CIGTS_TDP showed mild progression from 10.7 to 12.8 at 3-year follow-up (P = .01). No regional metrics showed worsening at follow-up examinations. Defects in the superior hemifield were more common than in the inferior hemifield at baseline and follow-up examinations for all regional metrics. Pre-operative number of glaucoma medications was associated with worsening on CIGTS_TDP. CONCLUSIONS: Overall, GDD surgery is effective at stabilizing VF function over 3 years of follow-up. The superior hemifield is affected more than other regions. The number of pre-operative glaucoma medications is associated with mild VF progression, measured by CIGTS_TDP.
Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA; Henan Eye Institute Henan Eye Hospital, Henan Provincial People's Hospital and Zhengzhou University People's Hospital, Zhengzhou, People's Republic of China.
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
