Abstract
Purpose :
Flavoprotein fluorescence (FPF) of the macula is an indicator of mitochondrial activity. FPF has been shown to be elevated in eyes with ocular hypertension and glaucoma, and may be useful in identifying patients with glaucoma prior to functional or structural changes. To date, no studies have evaluated FPF post-operatively, or stratified patients based on cataract history or glaucoma severity. The purpose of this study is to evaluate baseline and post-operative mitochondrial dysfunction in glaucoma patients undergoing glaucoma drainage device implantation, using retinal metabolic analysis (RMA).
Methods :
This was a prospective cohort study performed at the New York Eye and Ear Infirmary of Mount Sinai. Patients with a diagnosis of glaucoma were imaged with RMA before and after glaucoma drainage surgery. In one analysis, patients were categorized based on their history of cataracts and cataract surgery. In a separate analysis, patients were categorized as early, moderate, advanced, or severe based on Hodapp-Anderson-Parrish criteria. Flavoprotein fluorescence (FPF) of the macula was calculated using OcuSciences Retinal Metabolic Analysis machine.
Results :
45 eyes were imaged pre-operatively (mean ± SD age of 62.2 ± 17.1 years, 51% male). 26 of these eyes were imaged an average of 2.4 months post-operatively: 16 eyes which underwent surgery and 10 non-surgery eyes with a glaucoma diagnosis. Eyes with a history of intra-ocular lens (IOL) surgery had significantly lower FPF scores (78.57 ± 80.88) than eyes with no history of cataracts (224.35 ± 183.3, p=0.0022). FPF score was also shown to significantly increase with age for eyes with no history of IOL surgery (regression analysis p=0.0454) but not for IOL eyes (p=0.0976). No significant difference was found in FPF scores between glaucoma severity groups (p=0.247). Post-operatively, FPF scores tended to increase in both the surgery eye (182 ± 168.38 to 200.93 ± 131.46) and the non-surgery eye (125.3 ± 108.08 to 154.11 ± 120.36), although neither increase was significant.
Conclusions :
Both age and history of IOL surgery influence FPF scores and should be taken into account when analyzing RMA data. The increase in FPF in both eyes post-operatively may reflect a stress response, and longer follow-up is needed to assess how FPF changes over time after glaucoma surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.