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Dynamics of structural reversal in Bruch’s membrane opening-based morphometrics after glaucoma drainage device surgery

  • Glaucoma
  • Published:
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Abstract

Purpose

Structural reversal of disc cupping is a known phenomenon after trabeculectomy. The aim of this retrospective, longitudinal, cross-sectional analysis was to evaluate the postoperative dynamics of Bruch’s membrane opening-based morphometrics of the optic nerve head following glaucoma drainage device surgery.

Methods

Forty-three eyes, treated by glaucoma drainage device surgery, were included in the study. Individual changes in the spectral domain optic coherence tomography (SD-OCT) parameters Bruch’s membrane opening minimum rim width (BMO-MRW), Bruch’s membrane opening minimum rim area (BMO-MRA) and peripapillary retinal nerve fiber layer (RNFL) thickness as well as mean defect in 30–2 perimetry were analyzed. Changes were correlated to postoperative intraocular pressure levels over time. Available follow-up visits were aggregated and grouped into a short-term follow-up (20 to 180 days after surgery), a midterm follow-up (181 to 360 days after surgery) and a long-term follow-up (more than 360 days after surgery).

Results

In short-term follow-up, BMO-MRW and BMO-MRA increased significantly (p <= 0.034). This increase correlated negatively with the intraocular pressure at the time of the follow-up (Pearson’s rho = − 0.49; p = 0.039). From 6 months after surgery on, there was no statistically significant change in BMO-MRW and BMO-MRA (p >= 0.207). RNFL thickness and mean defect of 30–2 perimetry showed no significant changes after GDD implantation (p >= 0.189).

Conclusions

Lowering of intraocular pressure by glaucoma drainage device surgery leads to an increase of Bruch’s membrane opening based parameters in the first 6 months after surgery. These changes have to be taken into account when evaluating patients’ longitudinal follow-up after glaucoma drainage device implantation.

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References

  1. European Glaucoma Society (2017) Terminology and Guidelines for Glaucoma, 4th Edition. Br J Ophthalmol 101(5):73–127

    Google Scholar 

  2. Chauhan BC, O'Leary N, AlMobarak FA, Reis ASC, Yang H, Sharpe GP, Hutchison DM, Nicolela MT, Burgoyne CF (2013) Enhanced detection of open-angle glaucoma with an anatomically accurate optical coherence tomography-derived neuroretinal rim parameter. Ophthalmology 120(3):535–543

    PubMed  Google Scholar 

  3. Chauhan BC, Danthurebandara VM, Sharpe GP, Demirel S, Girkin CA, Mardin CY, Scheuerle AF, Burgoyne CF (2015) Bruch's membrane opening minimum rim width and retinal nerve fiber layer thickness in a normal white population: a multicenter study. Ophthalmology 122(9):1786–1794

    PubMed  PubMed Central  Google Scholar 

  4. Gardiner SK, Ren R, Yang H, Fortune B, Burgoyne CF, Demirel S (2014) A method to estimate the amount of neuroretinal rim tissue in glaucoma: comparison with current methods for measuring rim area. Am J Ophthalmol 157(3):540–549

    PubMed  Google Scholar 

  5. Enders P, Adler W, Kiessling D, Weber V, Schaub F, Hermann MM, Dietlein T, Cursiefen C, Heindl LM (2018) Evaluation of two-dimensional Bruch's membrane opening minimum rim area for glaucoma diagnostics in a large patient cohort. Acta Ophthalmol 24(10):13698

    Google Scholar 

  6. Enders P, Schaub F, Adler W, Hermann MM, Dietlein TS, Cursiefen C, Heindl LM (2018) Bruch's membrane opening-based optical coherence tomography of the optic nerve head: a useful diagnostic tool to detect glaucoma in macrodiscs. Eye 32(2):314–323

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Enders P, Schaub F, Adler W, Nikoluk R, Hermann MM, Heindl LM (2017) The use of Bruch's membrane opening-based optical coherence tomography of the optic nerve head for glaucoma detection in microdiscs. Br J Ophthalmol 101(4):530–535

    PubMed  Google Scholar 

  8. Gardiner SK, Boey PY, Yang H, Fortune B, Burgoyne CF, Demirel S (2015) Structural measurements for monitoring change in glaucoma: comparing retinal nerve fiber layer thickness with minimum rim width and area. Invest Ophthalmol Vis Sci 56(11):6886–6891

    PubMed  PubMed Central  Google Scholar 

  9. Enders P, Bremen A, Schaub F, Hermann MM, Diestelhorst M, Dietlein T, Cursiefen C, Heindl LM (2017) Intraday repeatability of Bruch's membrane opening-based neuroretinal rim measurements. Invest Ophthalmol Vis Sci 58(12):5195–5200

    PubMed  Google Scholar 

  10. Waisbourd M, Ahmed OM, Molineaux J, Gonzalez A, Spaeth GL, Katz LJ (2016) Reversible structural and functional changes after intraocular pressure reduction in patients with glaucoma. Graefes Arch Clin Exp Ophthalmol 254(6):1159–1166

    CAS  PubMed  Google Scholar 

  11. Quigley HA (1982) Childhood glaucoma: results with trabeculotomy and study of reversible cupping. Ophthalmology 89(3):219–226

    CAS  PubMed  Google Scholar 

  12. Katz LJ, Spaeth GL, Cantor LB, Poryzees EM, Steinmann WC (1989) Reversible optic disk cupping and visual field improvement in adults with glaucoma. Am J Ophthalmol 107(5):485–492

    CAS  PubMed  Google Scholar 

  13. Lesk MR, Spaeth GL, Azuara-Blanco A, Araujo SV, Katz LJ, Terebuh AK, Wilson RP, Moster MR, Schmidt CM (1999) Reversal of optic disc cupping after glaucoma surgery analyzed with a scanning laser tomograph. Ophthalmology 106(5):1013–1018

    CAS  PubMed  Google Scholar 

  14. Kotecha A, Siriwardena D, Fitzke FW, Hitchings RA, Khaw PT (2001) Optic disc changes following trabeculectomy: longitudinal and localisation of change. Br J Ophthalmol 85(8):956–961

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Parrish RK, Feuer WJ, Schiffman JC, Lichter PR, Musch DC (2009) Five-year follow-up optic disc findings of the collaborative initial glaucoma treatment study. Am J Ophthalmol 147(4):717–724

    PubMed  PubMed Central  Google Scholar 

  16. Gietzelt C, Lemke J, Schaub F, Hermann MM, Dietlein TS, Cursiefen C, Enders P, Heindl LM (2018) Structural reversal of disc cupping after trabeculectomy alters Bruch membrane opening-based parameters to assess neuroretinal rim. Am J Ophthalmol 194:143–152

    PubMed  Google Scholar 

  17. Kiessling D, Christ H, Gietzelt C, Schaub F, Dietlein TS, Cursiefen C, Heindl LM, Enders P (2018) Impact of ab-interno trabeculectomy on Bruch's membrane opening-based morphometry of the optic nerve head for glaucoma progression analysis. Graefes Arch Clin Exp Ophthalmol 28(10):018–4187

    Google Scholar 

  18. Molteno AC (1969) New implant for drainage in glaucoma. Animal trial. Br J Ophthalmol 53(3):161–168

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Molteno AC (1969) New implant for drainage in glaucoma. Clinical trial. Br J Ophthalmol 53(9):606–615

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Ramulu PY, Corcoran KJ, Corcoran SL, Robin AL (2007) Utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995 to 2004. Ophthalmology 114(12):2265–2270

    PubMed  Google Scholar 

  21. Dietlein TS, Rosentreter A (2018) Surgical options in Glaucoma management. Klin Monatsbl Augenheilkd 235(9):1013–1020

    PubMed  Google Scholar 

  22. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL (2012) Treatment outcomes in the tube versus trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol 153(5):789–803

    PubMed  PubMed Central  Google Scholar 

  23. Wang YW, Wang PB, Zeng C, Xia XB (2015) Comparison of the Ahmed glaucoma valve with the Baerveldt glaucoma implant: a meta-analysis. BMC Ophthalmol 15(132):015–0115

    Google Scholar 

  24. Hollo G (2017) Comparison of structure-function relationship between corresponding retinal nerve fibre layer thickness and Octopus visual field cluster defect values determined by normal and tendency-oriented strategies. Br J Ophthalmol 101(2):150–154

    PubMed  Google Scholar 

  25. King AJ, Taguri A, Wadood AC, Azuara-Blanco A (2002) Comparison of two fast strategies, SITA fast and TOP, for the assessment of visual fields in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 240(6):481–487

    CAS  PubMed  Google Scholar 

  26. Wadood AC, Azuara-Blanco A, Aspinall P, Taguri A, King AJ (2002) Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, and Humphrey Swedish interactive threshold algorithm-fast perimetry in a glaucoma practice. Am J Ophthalmol 133(3):327–332

    PubMed  Google Scholar 

  27. Rosentreter A, Gaki S, Lappas A, Cursiefen C, Dietlein TS (2013) Previous cyclodestruction is a risk factor for late-onset hypotony and suprachoroidal haemorrhage after glaucoma drainage device surgery. Br J Ophthalmol 97(6):715–719

    PubMed  Google Scholar 

  28. Mansberger SL, Menda SA, Fortune BA, Gardiner SK, Demirel S (2017) Automated segmentation errors when using optical coherence tomography to measure retinal nerve fiber layer thickness in glaucoma. Am J Ophthalmol 174:1–8

    PubMed  Google Scholar 

  29. Mariotti C, Nicolai M, Longo A, Viti F, Bambini E, Saitta A, Pirani V, Orsini E, Baruffa D, Reibaldi M (2017) Peripapillary retinal nerve fiber thickness changes after vitrectomy for epiretinal membrane in eyes with and without vitreous detachment. Retina 37(12):2304–2309

    PubMed  Google Scholar 

  30. Irak I, Zangwill L, Garden V, Shakiba S, Weinreb RN (1996) Change in optic disk topography after trabeculectomy. Am J Ophthalmol 122(5):690–695

    CAS  PubMed  Google Scholar 

  31. Topouzis F, Peng F, Kotas-Neumann R, Garcia R, Sanguinet J, Yu F, Coleman AL (1999) Longitudinal changes in optic disc topography of adult patients after trabeculectomy. Ophthalmology 106(6):1147–1151

    CAS  PubMed  Google Scholar 

  32. Fortune B, Yang H, Strouthidis NG, Cull GA, Grimm JL, Downs JC, Burgoyne CF (2009) The effect of acute intraocular pressure elevation on peripapillary retinal thickness, retinal nerve fiber layer thickness, and retardance. Invest Ophthalmol Vis Sci 50(10):4719–4726

    PubMed  PubMed Central  Google Scholar 

  33. Strouthidis NG, Fortune B, Yang H, Sigal IA, Burgoyne CF (2011) Longitudinal change detected by spectral domain optical coherence tomography in the optic nerve head and peripapillary retina in experimental glaucoma. Invest Ophthalmol Vis Sci 52(3):1206–1219

    PubMed  PubMed Central  Google Scholar 

  34. Coleman AL, Quigley HA, Vitale S, Dunkelberger G (1991) Displacement of the optic nerve head by acute changes in intraocular pressure in monkey eyes. Ophthalmology 98(1):35–40

    CAS  PubMed  Google Scholar 

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Acknowledgments

We thank all technical experts of our imaging laboratory and FOR 2240 “(Lymph-) Angiogenesis and Cellular Immunity in Inflammatory Diseases of the Eye” for their support (www.for2240.de).

Funding

No funding was received for this research.

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Author notes

  1. Ludwig M. Heindl and Philip Enders are co-senior authors

Authors and Affiliations

  1. Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50924, Cologne, Germany

    Caroline Gietzelt, Corinna von Goscinski, Julia Lemke, Friederike Schaub, Manuel M. Hermann, Thomas S. Dietlein, Claus Cursiefen, Ludwig M. Heindl & Philip Enders

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  1. Caroline Gietzelt
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  2. Corinna von Goscinski
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  3. Julia Lemke
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  5. Manuel M. Hermann
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  6. Thomas S. Dietlein
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  8. Ludwig M. Heindl
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  9. Philip Enders
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Contributions

Gietzelt C, Heindl L, Enders P, and Dietlein T participated in development of the trial protocol and contributed to drafting the manuscript. Gietzelt C, Enders P, Lemke J, and Goscinski C participated in the acquisition and the statistical evaluation of the data. All authors were involved in the interpretation of the results and discussion of the clinical significance. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Caroline Gietzelt.

Ethics declarations

According to regional medical regulations on retrospective single-centre clinical studies (§15 of the Professional code of conduct, General Medical Council for the Northern Rhine in accordance with the General Data Protection Regulation GDPR of the European Union), the Ethics Committee of the University of Cologne ruled that approval was not required for this retrospective analysis. Throughout the whole study, the 1964 Helsinki declaration and its later amendments as well as all applicable national regulations and laws were observed.

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The authors declare that they have no conflict of interest.

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Gietzelt, C., von Goscinski, C., Lemke, J. et al. Dynamics of structural reversal in Bruch’s membrane opening-based morphometrics after glaucoma drainage device surgery. Graefes Arch Clin Exp Ophthalmol 258, 1227–1236 (2020). https://doi.org/10.1007/s00417-020-04621-y

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  • DOI: https://doi.org/10.1007/s00417-020-04621-y

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