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

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Japanese Journal of Ophthalmology Aims and scope Submit manuscript

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.

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Acknowledgments

This study received financial support from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT) in the form of Innovative Techno-Hub for Integrated Medical Bio-Imaging of the Project for Developing Innovation Systems, and from the Japan Society for the Promotion of Science (JSPS) (Kakenhi Grant Nos. 24592624 and 25462713).

Conflicts of interest

M. Yoshikawa, None; T. Akagi, Lecture fees (Alcon, Kowa, Pfizer, Santen, Senju); H. Nakanishi, None; H. O. Ikeda, Grants (Banyu Foundation, Japan Intractable Diseases Research Foundation, Japan Research Foundation for Clinical Pharmacology, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Uehara Memorial Foundation, YOKOYAMA Foundation for Clinical Pharmacology); S. Morooka, None; H. Yamada, None; T. Hasegawa, None; Y. Iida, None; N. Yoshimura, Grants (Alcon, Bayer, MSD, Novartis, Ohtsuka, Santen, Senju), Consultant fees (Alcon, Bayer, Canon, Japan Focus, Kowa, MSD, Nidek, Novartis, Ohtsuka, Santen, Senju).

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

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

  2. Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan

    Hanako Ohashi Ikeda

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  1. Munemitsu Yoshikawa
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  2. Tadamichi Akagi
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Corresponding author

Correspondence to Tadamichi Akagi.

Electronic supplementary material

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10384_2016_482_MOESM1_ESM.tif

Supplementary Fig. 1 Scatterplots of 3 independent variables: choroidal thickness (ChT), age, and axial length (AL). (a) In our dataset, the older patients had shorter ALs (ρ = -0.745, P < 0.001; Spearman rank correlation). (b) In the univariate analysis, age and ChT were not significantly associated (ρ = -0.019, P = 0.94), probably because of the confounding bias between age and AL. (c) The patients with longer ALs tended to have thinner ChTs (ρ = -0.541, P = 0.030) (TIFF 101 kb)

10384_2016_482_MOESM2_ESM.tif

Supplementary Fig. 2 Scatterplots of the percentage decrease in intraocular pressure (IOP) against the percentage increase in choroidal thickness (ChT) at the postoperative 1-month (a), 3-month (b), and 6-month (c) stages. In the univariate analysis, the percentage increase in ChT was not significantly associated with the percentage decrease in IOP, as shown in Table 4 (TIFF 101 kb)

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Yoshikawa, M., Akagi, T., Nakanishi, H. et al. Longitudinal change in choroidal thickness after trabeculectomy in primary open-angle glaucoma patients. Jpn J Ophthalmol 61, 105–112 (2017). https://doi.org/10.1007/s10384-016-0482-9

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  • DOI: https://doi.org/10.1007/s10384-016-0482-9

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