Abstract
Purpose: :
To evaluate the IOP reduction and the safety of the procedure in patients receiving Pneumatic Trabeculoplasty (PNT) and to analyze functional and morphological effect on optic nerve head and RNFL.Pneumatic trabeculoplasty is a procedure, which aims at reducing intraocular pressure (IOP), which has been recently approved by the European regulatory authorities for clinical use.
Methods: :
30 eyes of 30 patients with ocular hypertension, both untreated and treated after a proper wash-out period were submitted to PNT. Patients underwent to a baseline visit in order to verify inclusion and exclusion criteria, comprehensive of BCVA, biomicroscopy, daytime IOP curve, gonioscopy, visual field testing and optic nerve head and RNFL imaging by means of HRT and SD OCT. After baseline were submitted to treatment at day 0, day 7 and day 90. Safety visit were conducted the days after the procedures. IOP was measured at days 15, 30, 60, 105 and 180. BCVA, visual field, SD OCT and HRT were repeated at day 180.
Results: :
25 of 30 eyes completed the follow up, 3 eyes were ruled out after IOP raised up over 26 mmHg, 2 patients (N=2) referred pain and red eye for 7 days after treatment and preferred to stop the treatment. Mean IOP of the 25 eyes was 22.7 + 1.5 mmHg at baseline, at day 180 mean IOP was 19.2 + 1.6 mmHg with a mean reduction of 3.5 + 1.4 mmHg. Baseline visual field defect did not change at day 180, morphological studies (RNFL SD OCT, HRT) did not showed significative changes. Mean BCVA, measured in decimal units, was 0.73 at baseline and 0.71 at the end of our follow-up.
Conclusions: :
In this study we found a significant IOP decrease compared to baseline, 2 eyes were ruled out because of side effects always resolved without sequelae and 3 because of raising up of IOP. In our study no visual field changes were found after PNT, RNFL study did not showed changes during 6 months follow-up. The efficacy of PNT must be confirmed by long term data, but its effectiveness could reduce number of people treated by antiglacomatous drops lowering the allocated expenses for health.
Keywords: intraocular pressure • clinical (human) or epidemiologic studies: outcomes/complications • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)