Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Japanese Journal of Ophthalmology
Published in: Japanese Journal of Ophthalmology 1/2017

01-01-2017 | Clinical Investigation

Longitudinal change in choroidal thickness after trabeculectomy in primary open-angle glaucoma patients

Authors: Munemitsu Yoshikawa, Tadamichi Akagi, Hideo Nakanishi, Hanako Ohashi Ikeda, Satoshi Morooka, Hiroshi Yamada, Tomoko Hasegawa, Yuto Iida, Nagahisa Yoshimura

Published in: Japanese Journal of Ophthalmology | Issue 1/2017

Login to get access

Abstract

Purpose

To investigate longitudinal changes in intraocular pressure (IOP), axial length (AL), and choroidal thickness (ChT) in primary open-angle glaucoma (POAG) eyes after trabeculectomy and to evaluate the parameters that might influence those changes.

Methods

In this prospective observational study, we recruited 28 patients with POAG (28 eyes) scheduled for trabeculectomy. The average macular ChTs and foveal retinal thicknesses along 6-mm segments centered on the fovea were examined preoperatively and postoperatively (at 1, 3, and 6 months) using swept-source optical coherence tomography. The IOP, AL, and mean deviation (MD) of standard automated perimetry (SAP) were also analyzed as independent variables.

Results

Results from 16 patients were included in the final analysis. A significant increase in ChT with respect to the preoperative value was observed at every postoperative stage (1 month, P < 0.001; 3 months, P < 0.001; 6 months, P = 0.011), whereas the retinal thickness showed no significant change over the study period. The ChT increase and IOP reduction were sustained throughout the 6-month period without further significant changes. Stepwise multivariate analyses showed significant correlations between the percentage decrease in IOP and the percentage increase in ChT at 1 and 6 months postoperatively. The percentage increase in ChT was also significantly correlated with a better MD of the SAP at 1 month (β = 0.01; P = 0.009).

Conclusions

The ChT increase following trabeculectomy was sustained at 1, 3, and 6 months postoperatively. The percentage increase in ChT was significantly correlated with the percentage change in IOP and (more weakly) with better SAP MD values.
Appendix
Available only for authorised users
Literature
1.
Tham Y-C, Li X, Wong TY, Quigley HA, Aung T, Cheng C-Y. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121:2081–90.CrossRefPubMed
2.
The AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. Am J Ophthalmol. 2000;130:429–40.CrossRef
3.
Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK. Visual field progression in the Collaborative Initial Glaucoma Treatment Study: the impact of treatment and other baseline factors. Ophthalmology. 2009;116:200–7.CrossRefPubMed
4.
Fannin LA, Schiffman JC, Budenz DL. Risk factors for hypotony maculopathy. Ophthalmology. 2003;110:1185–91.CrossRefPubMed
5.
Rulli E, Biagioli E, Riva I, Gambirasio G, De Simone I, Floriani I, et al. Efficacy and safety of trabeculectomy vs nonpenetrating surgical procedures: a systematic review and meta-analysis. JAMA Ophthalmol. 2013;131:1573–82.CrossRefPubMed
6.
Stamper RL, McMenemy MG, Lieberman MF. Hypotonous maculopathy after trabeculectomy with subconjunctival 5-fluorouracil. Am J Ophthalmol. 1992;114:544–53.CrossRefPubMed
7.
Reis ASC, O’Leary N, Stanfield MJ, Shuba LM, Nicolela MT, Chauhan BC. Laminar displacement and prelaminar tissue thickness change after glaucoma surgery imaged with optical coherence tomography. Invest Ophthalmol Vis Sci. 2012;53:5819–26.CrossRefPubMed
8.
Yoshikawa M, Akagi T, Hangai M, Ohashi-Ikeda H, Takayama K, Morooka S, et al. Alterations in the neural and connective tissue components of glaucomatous cupping after glaucoma surgery using swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2014;55:477–84.CrossRefPubMed
9.
Lee EJ, Kim TW, Weinreb RN. Reversal of lamina cribrosa displacement and thickness after trabeculectomy in glaucoma. Ophthalmology. 2012;119:1359–66.CrossRefPubMed
10.
Usui S, Ikuno Y, Uematsu S, Morimoto Y, Yasuno Y, Otori Y. Changes in axial length and choroidal thickness after intraocular pressure reduction resulting from trabeculectomy. Clin Ophthalmol. 2013;7:1155–61.CrossRefPubMedPubMedCentral
11.
Saeedi O, Pillar A, Jefferys J, Arora K, Friedman D, Quigley H. Change in choroidal thickness and axial length with change in intraocular pressure after trabeculectomy. Br J Ophthalmol. 2014;98:976–9.CrossRefPubMed
12.
Kara N, Baz O, Altan C, Satana B, Kurt T, Demirok A. Changes in choroidal thickness, axial length, and ocular perfusion pressure accompanying successful glaucoma filtration surgery. Eye (Lond). 2013;27:940–5.CrossRef
13.
Agoumi Y, Sharpe GP, Hutchison DM, Nicolela MT, Artes PH, Chauhan BC. Laminar and prelaminar tissue displacement during intraocular pressure elevation in glaucoma patients and healthy controls. Ophthalmology. 2011;118:52–9.CrossRefPubMed
14.
Hata M, Hirose F, Oishi A, Hirami Y, Kurimoto Y. Changes in choroidal thickness and optical axial length accompanying intraocular pressure increase. Jpn J Ophthalmol. 2012;56:564–8.CrossRefPubMed
15.
Marcus MW, de Vries MM, Junoy Montolio FG, Jansonius NM. Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. Ophthalmology. 2011;118(1989–94):e2.
16.
Lopilly-Park HY, Jeon SH, Park CK. Enhanced depth imaging detects lamina cribrosa thickness differences in normal tension glaucoma and primary open-angle glaucoma. Ophthalmology. 2012;119:10–20.CrossRef
17.
Inoue R, Hangai M, Kotera Y, Nakanishi H, Mori S, Morishita S, et al. Three-dimensional high-speed optical coherence tomography imaging of lamina cribrosa in glaucoma. Ophthalmology. 2009;116:214–22.CrossRefPubMed
18.
Lee EJ, Kim TW, Kim M, Kim H. Influence of lamina cribrosa thickness and depth on the rate of progressive retinal nerve fiber layer thinning. Ophthalmology. 2015;122:721–9.CrossRefPubMed
19.
Maul EA, Friedman DS, Chang DS, Boland MV, Ramulu PY, Jampel HD, et al. Choroidal thickness measured by spectral domain optical coherence tomography: factors affecting thickness in glaucoma patients. Ophthalmology. 2011;118:1571–9.CrossRefPubMedPubMedCentral
20.
Mwanza JC, Hochberg JT, Banitt MR, Feuer WJ, Budenz DL. Lack of association between glaucoma and macular choroidal thickness measured with enhanced depth-imaging optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52:3430–5.CrossRefPubMedPubMedCentral
21.
Mwanza JC, Sayyad FE, Budenz DL. Choroidal thickness in unilateral advanced glaucoma. Invest Ophthalmol Vis Sci. 2012;53:6695–701.CrossRefPubMed
22.
Rhew JY, Kim YT, Choi KR. Measurement of subfoveal choroidal thickness in normal-tension glaucoma in Korean patients. J Glaucoma. 2014;23:46–9.CrossRefPubMed
23.
Wang W, Zhang X. Choroidal thickness and primary open-angle glaucoma: a cross-sectional study and meta-analysis. Invest Ophthalmol Vis Sci. 2014;55:6007–14.CrossRefPubMed
24.
Zhang Z, Yu M, Wang F, Dai Y, Wu Z. Choroidal thickness and open-angle glaucoma: a meta-analysis and systematic review. J Glaucoma. 2016;25:e446–54.CrossRefPubMed
25.
Jonas JB, Steinmetz P, Forster TM, Schlichtenbrede FC, Harder BC. Choroidal thickness in open-angle glaucoma. J Glaucoma. 2015;24:619–23.CrossRefPubMed
26.
Ehrlich JR, Peterson J, Parlitsis G, Kay KY, Kiss S, Radcliffe NM. Peripapillary choroidal thickness in glaucoma measured with optical coherence tomography. Exp Eye Res. 2011;92:189–94.CrossRefPubMed
27.
Li L, Bian A, Zhou Q, Mao J. Peripapillary choroidal thickness in both eyes of glaucoma patients with unilateral visual field loss. Am J Ophthalmol. 2013;156(1277–84):e1.CrossRef
28.
Hirooka K, Tenkumo K, Fujiwara A, Baba T, Sato S, Shiraga F. Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma. BMC Ophthalmol. 2012;12:29.CrossRefPubMedPubMedCentral
29.
Park HY, Lee NY, Shin HY, Park CK. Analysis of macular and peripapillary choroidal thickness in glaucoma patients by enhanced depth imaging optical coherence tomography. J Glaucoma. 2014;23:225–31.PubMed
30.
Roberts KF, Artes PH, O’Leary N, Reis ASC, Sharpe GP, Hutchison DM, et al. Peripapillary choroidal thickness in healthy controls and patients with focal, diffuse, and sclerotic glaucomatous optic disc damage. Arch Ophthalmol. 2012;130:980–6.CrossRefPubMed
31.
Sigler EJ, Mascarenhas KG, Tsai JC, Loewen NA. Clinicopathologic correlation of disc and peripapillary region using SD-OCT. Optom Vis Sci. 2013;90:84–93.CrossRefPubMedPubMedCentral
32.
Usui S, Ikuno Y, Miki A, Matsushita K, Yasuno Y, Nishida K. Evaluation of the choroidal thickness using high-penetration optical coherence tomography with long wavelength in highly myopic normal-tension glaucoma. Am J Ophthalmol. 2012;153(10–6):e1.
33.
Yamada H, Akagi T, Nakanishi H, Ikeda HO, Kimura Y, Suda K, et al. Microstructure of peripapillary atrophy and subsequent visual field progression in treated primary open-angle glaucoma. Ophthalmology. 2016;123:542–51.CrossRefPubMed
34.
Kim YW, Lee EJ, Kim TW, Kim M, Kim H. Microstructure of β-zone parapapillary atrophy and rate of retinal nerve fiber layer thinning in primary open-angle glaucoma. Ophthalmology. 2014;121:1341–9.CrossRefPubMed
35.
Lee EJ, Kim TW. Lamina cribrosa reversal after trabeculectomy and the rate of progressive retinal nerve fiber layer thinning. Ophthalmology. 2015;122:2234–42.CrossRefPubMed
36.
Hirata M, Tsujikawa A, Matsumoto A, Hangai M, Ooto S, Yamashiro K, et al. Macular choroidal thickness and volume in normal subjects measured by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52:4971–8.CrossRefPubMed
37.
Akagi T, Hangai M, Kimura Y, Ikeda HO, Nonaka A, Matsumoto A, et al. Peripapillary scleral deformation and retinal nerve fiber damage in high myopia assessed with swept-source optical coherence tomography. Am J Ophthalmol. 2013;155:927–36.CrossRefPubMed
38.
39.
Wei WB, Xu L, Jonas JB, Shao L, Du KF, Wang S, et al. Subfoveal choroidal thickness: the Beijing Eye Study. Ophthalmology. 2013;120:175–80.CrossRefPubMed
40.
41.
Riva CE, Titze P, Hero M, Petrig BL. Effect of acute decreases of perfusion pressure on choroidal blood flow in humans. Invest Ophthalmol Vis Sci. 1997;38:1752–60.PubMed
42.
Delaey C, Van de Voorde J. Regulatory mechanisms in the retinal and choroidal circulation. Ophthalmic Res. 2000;32:249–56.CrossRefPubMed
43.
Noda Y, Ogawa A, Toyama T, Ueta T. Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts. Am J Ophthalmol. 2014;158(455–9):e1.
44.
Leske MC, Wu SY, Hennis A, Honkanen R, Nemesure B. Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. Ophthalmology. 2008;115:85–93.CrossRefPubMed
45.
Schmidl D, Garhofer G, Schmetterer L. The complex interaction between ocular perfusion pressure and ocular blood flow—relevance for glaucoma. Exp Eye Res. 2011;93:141–55.CrossRefPubMed
46.
Flammer J, Orgül S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, et al. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res. 2002;21:359–93.CrossRefPubMed
47.
Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007;114:1965–72.CrossRefPubMed
48.
Tielsch JM, Katz J, Sommer A, Quigley HA, Javitt JC. Hypertension, perfusion pressure, and primary open-angle glaucoma: a population-based assessment. Arch Ophthalmol. 1995;113:216–21.CrossRefPubMed
49.
Usui S, Ikuno Y, Akiba M, Maruko I, Sekiryu T, Nishida K, et al. Circadian changes in subfoveal choroidal thickness and the relationship with circulatory factors in healthy subjects. Invest Ophthalmol Vis Sci. 2012;53:2300–7.CrossRefPubMed
50.
Saito M, Kano M, Itagaki K, Ise S, Imaizumi K, Sekiryu T. Subfoveal choroidal thickness in polypoidal choroidal vasculopathy after switching to intravitreal aflibercept injection. Jpn J Ophthalmol. 2016;60:35–41.CrossRefPubMed
51.
Lee TG, Yu SY, Kwak HW. Variations in choroidal thickness after high-dose systemic corticosteroid treatment in children with chronic glomerulonephritis. Retina. 2015;35:2567–73.CrossRefPubMed
52.
Hashimoto Y, Saito W, Saito M, Hirooka K, Mori S, Noda K, et al. Increased choroidal blood flow velocity with regression of unilateral acute idiopathic maculopathy. Jpn J Ophthalmol. 2015;59:252–60.CrossRefPubMed
Metadata
Title
Longitudinal change in choroidal thickness after trabeculectomy in primary open-angle glaucoma patients
Authors
Munemitsu Yoshikawa
Tadamichi Akagi
Hideo Nakanishi
Hanako Ohashi Ikeda
Satoshi Morooka
Hiroshi Yamada
Tomoko Hasegawa
Yuto Iida
Nagahisa Yoshimura
Publication date
01-01-2017
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 1/2017
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-016-0482-9

Other articles of this Issue 1/2017

Japanese Journal of Ophthalmology 1/2017 Go to the issue

Clinical Investigation

Wound stability and surgically induced corneal astigmatism after transconjunctival single-plane sclerocorneal incision cataract surgery

Clinical Investigation

The effect of the extent of the incision in the Schlemm canal on the surgical outcomes of suture trabeculotomy for open-angle glaucoma

Clinical Investigation

Comparison between ranibizumab and aflibercept for macular edema associated with central retinal vein occlusion

Clinical Investigation

Eyelid cleansing with ointment for obstructive meibomian gland dysfunction

Clinical Investigation

Retreatment of polypoidal choroidal vasculopathy after photodynamic therapy combined with intravitreal ranibizumab

Clinical Investigation

Effect of leaking perifoveal microaneurysms on resolution of diabetic macular edema treated by combination therapy using anti-vascular endothelial growth factor and short pulse focal/grid laser photocoagulation