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Kazuyuki Hirooka, Hirokazu Kojima, Eri Nitta, Kaori Ukegawa, Shozo Sonoda, Taiji Sakamoto; Changes in choroidal area after intraocular pressure reduction following trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):461.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate changes of the macular and peripapillary choroidal areas after trabeculectomy.
This prospective and interventional study examined 74 eyes of 74 patients with glaucoma uncontrolled by medical therapy. Enhanced depth imaging optical coherence tomography (EDI-OCT) recorded macular and peripapillary choroidal images at 1 day before trabeculectomy and at 2 weeks after surgery. Subjects were excluded if they had any history of retinal diseases, had undergone previous laser therapy, had poor image quality due to unstable fixation, or if they had severe cataract. The Niblack method was used to covert luminal and interstitial areas to binary images. Preoperative and postoperative values were compared by a paired t-test.
At baseline, the mean intraocular pressure (IOP) was 17.6±6.3 mmHg, while it was 6.5±2.9 mmHg after trabeculectomy (P < 0.001). Increases were observed for the macular choroidal area after the surgery, with the total area increasing from 317,853±95,728 μm2 to 368,597±104,393 μm2, while the luminal area increased from 210,355±73,650 μm2 to 249,464±77,195 μm2, and the interstitial area increased from 107,498±27,613 μm2 to 119,133±31,811 μm2 (all P < 0.001). Increases were also observed after the surgery for the peripapillary choroidal area, with the total area increasing from 1,629,440±460,429 μm2 to 1,974,289±500,496 μm2, while the luminal area increased from 920,141±328,690 μm2 to 1,179,843±357,601 μm2, and the interstitial area increased from 709,299±153,179 μm2 to 794,446±169,029 μm2 (all P < 0.001). There was a significant increase in the ratio of the luminal to choroidal area in the macular area (67.2%) and in the peripapillary area (59.1%). Factors associated with the changes in the peripapillary choroidal area included decreases in the diastolic blood pressure and IOP.
A reduction in the IOP after trabeculectomy led to increases in the macular and peripapillary choroidal areas. Observed changes in the choroidal area after trabeculectomy are primarily due to increases in the luminal areas.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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