June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Optic Nerve Head Changes After Intraocular Pressure Lowering Glaucoma Surgeries Detected with Swept-Source Optical Coherence Tomography
Author Affiliations & Notes
  • Victoria d'Azevedo Silveira
    Ophthalmology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
    Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
  • Rodrigo Leivas Lindenmeyer
    Ophthalmology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
  • Helena Messinger Pakter
    Ophthalmology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
    Ophthalmology, Hospital Conceicao, Porto Alegre, Rio Grande do Sul, Brazil
  • Alon Skaat
    Ophthalmology, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
  • Daniel Lavinsky
    Ophthalmology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
    Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
  • Egidio Picetti
    Ophthalmology, Hospital Conceicao, Porto Alegre, Rio Grande do Sul, Brazil
  • Paulo Augusto de Arruda Mello
    Ophthalmology, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Fabio Lavinsky
    Ophthalmology, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
    School of Medicine, Universidade do Vale do Rio dos Sinos, Sao Leopoldo, RS, Brazil
  • Footnotes
    Commercial Relationships   Victoria Silveira None; Rodrigo Lindenmeyer None; Helena Pakter None; Alon Skaat None; Daniel Lavinsky None; Egidio Picetti None; Paulo Augusto Mello None; Fabio Lavinsky None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2425 – A0359. doi:
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    • Get Citation

      Victoria d'Azevedo Silveira, Rodrigo Leivas Lindenmeyer, Helena Messinger Pakter, Alon Skaat, Daniel Lavinsky, Egidio Picetti, Paulo Augusto de Arruda Mello, Fabio Lavinsky; Optic Nerve Head Changes After Intraocular Pressure Lowering Glaucoma Surgeries Detected with Swept-Source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2425 – A0359.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this study is to detect optic nerve head (ONH) changes with swept-source optical coherence tomography (SS-OCT) evaluated with the hypotenuse of the ONH cupping (HOC) after intraocular pressure (IOP) lowering procedures.

Methods : Subjects with progressing glaucoma presenting typical ONH and SS-OCT findings that were referred to IOP-lowering glaucoma procedures were included. Patients underwent 24-2 perimetry (SITA standard; Humphrey Field Analyzer; Zeiss) and SS-OCT (DRI-Triton; Topcon) using the wide-field 9mmx12mm raster scan. IOP and SS-OCT scans were obtained at the preoperative period (pre-op), up to 7 days (PO1) and between 30 to 90 days post-operatively (PO2). A B-scan at the center of optic disc and an average of five central B-scans were used to calculate the ONH parameters. HOC was calculated using the Pythagorean theorem: hypotenuse2 = leg12 + leg22 using the length and depth of the cupping as the legs of a right triangle (figure 1). We also evaluated the change of the BMO-to-BMO extension. Statistical analysis was performed using Generalized estimating equations (GEE).

Results : Fifteen eyes (12 subjects) qualified for the study and underwent the 3 visits. The average age was 70±11.04 years. At the baseline, the average circumpapillary retinal nerve fiber layer (cRNFL) was 60.13±23.21 µm and the visual field (VF) mean deviation (MD) was -13.29±8.5 DB. The mean IOP on each visit (pre-op, PO1 and PO2) were: 20.5±4.99; 11±4.95 and 15.7±5.04, respectively (p<0.01). Average HOC decreased significantly after the IOP-lowering procedures (p=0.001), markedly between pre-op to PO1. The average components of HOC, depth and lenght, and the BMO-to-BMO extension also decreased significantly (table 1). There was no significant change from PO1 to PO2 in all parameters.

Conclusions : HOC evaluated with SS-OCT significantly decreased after IOP-lowering surgeries to treat progressing glaucoma. This biomarker may be useful to evaluate short-term ONH changes. Notwithstanding, a longer follow-up is needed to determine the persistence of these changes.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure 1. HOC measurement method: B-scan at the center of the disc is selected (arrow head). Length (arrow) was measured between the innermost portion of the descending RNFL tissue at the BMO plan and depth (star) was measured between the former line and the maximum depth of the prelaminar tissue.

Figure 1. HOC measurement method: B-scan at the center of the disc is selected (arrow head). Length (arrow) was measured between the innermost portion of the descending RNFL tissue at the BMO plan and depth (star) was measured between the former line and the maximum depth of the prelaminar tissue.

 

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