Association Between Structure-function Characteristics and Visual Field Outcomes in Glaucoma Subjects With Intraocular Pressure Reduction After Trabeculectomy.

Abstract

PRECIS:

Improvements in post-trabeculectomy visual field (VF) outcomes were found to be significantly associated with preoperative nerve fiber layer thickness parameters extracted from the sectorized structure-function relationship, baseline VF, and severity of glaucoma.

OBJECTIVE:

To determine whether the preoperative structure-function relationship helps to predict visual outcomes at 1-year post-trabeculectomy.

PATIENTS AND METHODS:

In total, 91 eyes from 87 participants who successfully underwent trabeculectomy were included in our study. All eyes received optical coherence tomography imaging and VF assessment using 30-2 standard automated perimetry preoperatively at baseline and postoperatively 1 year after trabeculectomy. The linear mixed-model analysis was used to assess the association of structure and function at baseline, and multivariate analysis to investigate factors associated with postoperative VF outcomes.

RESULTS:

Results from multivariate and univariate analysis for VF 1 year after trabeculectomy showed that a positive preoperative retinal nerve fiber layer thickness deviation from the structure-function model was found to be significantly associated with improved postoperative VF outcomes [β=0.06 dB/μm; 95% confidence interval (CI), 0.03-0.09]. Other significant factors included baseline VF MD (β=-0.18; 95% CI, -0.23 to -0.13) and the presence of severe glaucoma (β=-1.69; 95% CI, -2.80 to -0.57). Intraocular pressure was positively associated with improved VF outcomes only in univariate analysis (β=0.06; 95% CI, 0.01-0.11).

CONCLUSIONS AND RELEVANCE:

Characteristics derived from the baseline structure-function relationship were found to be strongly associated with postoperative VF outcomes. These findings suggest that the structure-function relationship could potentially have a role in predicting VF progression after trabeculectomy.

• Authors: Aistė Kadziauskienė, Jacqueline Chua, Mani Baskaran, Ai Ping Yow, Bingyao Tan, Chelvin Sng, Rimvydas Ašoklis, Eugenijus Lesinskas, Jonathan Crowston, Leopold Schmetterer, Damon Wing Kee Wong
• Journal: Journal of glaucoma (J Glaucoma) Vol. 29 Issue 8 Pg. 648-655 (08 2020) ISSN: 1536-481X [Electronic] United States
• PMID: 32487949 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Disease Progression
• Female
• Glaucoma, Angle-Closure (physiopathology, surgery)
• Glaucoma, Open-Angle (physiopathology, surgery)
• Humans
• Intraocular Pressure (physiology)
• Male
• Middle Aged
• Ocular Hypotension (physiopathology, surgery)
• Prospective Studies
• Tomography, Optical Coherence (methods)
• Tonometry, Ocular
• Trabeculectomy
• Visual Field Tests
• Visual Fields (physiology)