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Improved retinal function after trabeculectomy in glaucoma patients.

Wittström, Elisabeth; Schatz, Patrik LU ; Lövestam Adrian, Monica LU ; Ponjavic, Vesna LU ; Bergström, Anders LU and Andréasson, Sten LU (2010) In Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 248. p.485-495
Abstract
PURPOSE: To investigate retinal function after reduction of intraocular pressure (IOP) by filtration surgery in patients with medically uncontrolled glaucoma. METHODS: Eleven patients (11 eyes) with medically uncontrolled glaucoma underwent trabeculectomy. Clinical investigation, visual field (testing with standard automated perimetry (SAP-Humphrey), optical coherence tomography (OCT), full-field electroretinography (full-field ERG) and multifocal electroretinography (mfERG) were performed preoperatively as well as 2 and 6 months after surgery. DESIGN: Interventional prospective, consecutive case series. RESULTS: No significant reduction was seen in mean log MAR visual acuity 2 or 6 months after filtration surgery. The mean preoperative... (More)
PURPOSE: To investigate retinal function after reduction of intraocular pressure (IOP) by filtration surgery in patients with medically uncontrolled glaucoma. METHODS: Eleven patients (11 eyes) with medically uncontrolled glaucoma underwent trabeculectomy. Clinical investigation, visual field (testing with standard automated perimetry (SAP-Humphrey), optical coherence tomography (OCT), full-field electroretinography (full-field ERG) and multifocal electroretinography (mfERG) were performed preoperatively as well as 2 and 6 months after surgery. DESIGN: Interventional prospective, consecutive case series. RESULTS: No significant reduction was seen in mean log MAR visual acuity 2 or 6 months after filtration surgery. The mean preoperative intraocular pressure of 27.1 (+/-6.2) mmHg decreased to 19.0(+/-6.1) mmHg 2 months after surgery and to 17.1 (+/- 3.4) mmHg 6 months after surgery (both p = 0.001). The reduction in IOP significantly decreased the number of anti-glaucoma agents used, from 3.7 +/- 1.6 at baseline to 0.8 +/- 0.9 2 months after surgery and to 1.3 +/- 1.2 6 months after surgery (p = 0.004 and p = 0.008 respectively). The results of SAP, OCT and full-field ERG did not show any significant difference between pre- and postoperative values at any point in time. No significant improvement was found with regard to the first positive peak (P(1)) amplitudes in the macular retina (area 1) or in the perimacular retina/periphery (area 2) when measured with mfERG 2 months after surgery. The mfERG examinations revealed significantly improved P(1) amplitudes 6 months after surgery in both area 1 and area 2, compared with the preoperative values (p = 0.042 and p = 0.014 respectively). The implicit time of P(1) decreased significantly 6 months after surgery in area 2 compared with the preoperative values (p = 0.023). CONCLUSION: A significant lowering of IOP seems to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with mfERG. (Less)
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organization
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Contribution to journal
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published
subject
in
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
volume
248
pages
485 - 495
publisher
Springer
external identifiers
  • WOS:000275105200004
  • PMID:19865823
  • Scopus:77949270213
ISSN
1435-702X
DOI
10.1007/s00417-009-1220-5
language
English
LU publication?
yes
id
c11b585a-00e3-4c45-9e91-04387670725e (old id 1499884)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19865823?dopt=Abstract
date added to LUP
2009-11-03 09:28:56
date last changed
2016-10-13 04:30:07
@misc{c11b585a-00e3-4c45-9e91-04387670725e,
  abstract     = {PURPOSE: To investigate retinal function after reduction of intraocular pressure (IOP) by filtration surgery in patients with medically uncontrolled glaucoma. METHODS: Eleven patients (11 eyes) with medically uncontrolled glaucoma underwent trabeculectomy. Clinical investigation, visual field (testing with standard automated perimetry (SAP-Humphrey), optical coherence tomography (OCT), full-field electroretinography (full-field ERG) and multifocal electroretinography (mfERG) were performed preoperatively as well as 2 and 6 months after surgery. DESIGN: Interventional prospective, consecutive case series. RESULTS: No significant reduction was seen in mean log MAR visual acuity 2 or 6 months after filtration surgery. The mean preoperative intraocular pressure of 27.1 (+/-6.2) mmHg decreased to 19.0(+/-6.1) mmHg 2 months after surgery and to 17.1 (+/- 3.4) mmHg 6 months after surgery (both p = 0.001). The reduction in IOP significantly decreased the number of anti-glaucoma agents used, from 3.7 +/- 1.6 at baseline to 0.8 +/- 0.9 2 months after surgery and to 1.3 +/- 1.2 6 months after surgery (p = 0.004 and p = 0.008 respectively). The results of SAP, OCT and full-field ERG did not show any significant difference between pre- and postoperative values at any point in time. No significant improvement was found with regard to the first positive peak (P(1)) amplitudes in the macular retina (area 1) or in the perimacular retina/periphery (area 2) when measured with mfERG 2 months after surgery. The mfERG examinations revealed significantly improved P(1) amplitudes 6 months after surgery in both area 1 and area 2, compared with the preoperative values (p = 0.042 and p = 0.014 respectively). The implicit time of P(1) decreased significantly 6 months after surgery in area 2 compared with the preoperative values (p = 0.023). CONCLUSION: A significant lowering of IOP seems to improve the function of the central retina, as demonstrated by increased amplitudes and reduced implicit times assessed with mfERG.},
  author       = {Wittström, Elisabeth and Schatz, Patrik and Lövestam Adrian, Monica and Ponjavic, Vesna and Bergström, Anders and Andréasson, Sten},
  issn         = {1435-702X},
  language     = {eng},
  pages        = {485--495},
  publisher    = {ARRAY(0xcefeb60)},
  series       = {Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie},
  title        = {Improved retinal function after trabeculectomy in glaucoma patients.},
  url          = {http://dx.doi.org/10.1007/s00417-009-1220-5},
  volume       = {248},
  year         = {2010},
}