Optic Nerve Head Changes After Intraocular Pressure-Lowering Glaucoma Surgeries Using Optical Coherence Tomography

• Published in: Journal of glaucoma
• Main Authors: Silveira, Victoria d'Azevedo, Lindenmeyer, Rodrigo Leivas, Pakter, Helena Messinger, Skaat, Alon, Lavinsky, Daniel, Oliveira, Monica, Picceti, Egidio, Lavinsky, Jaco, de Arruda Mello, Paulo Augusto, Lavinsky, Fabio
• Format: Journal Article
• Language: English
• Published: United States 01.09.2023
• ISSN: 1536-481X
• DOI: 10.1097/IJG.0000000000002242

Optic nerve head changes were detected with swept-source optical coherence tomography after intraocular pressure-lowering glaucoma surgeries. The aim of this study was to detect changes in the optic nerve head with swept-source optical coherence tomography (SS-OCT) after intraocular pressure-lowering procedures. Patients with progressing glaucoma who were referred for intraocular pressure-lowering procedures were included. The participants underwent a 24-2 visual field test and SS-OCT (DRI OCT Triton Plus; Topcon, Tokyo, Japan). Intraocular pressure and SS-OCT scans were obtained during the preoperative period and up to 7 days and 30-90 days postoperatively. Optic nerve head parameters were measured with a B-scan at the center of the optic disc and an average of 5 central B-scans. The hypotenuse of the optic nerve head cup was calculated using the Pythagorean theorem: hypotenuse2 = leg12 + leg22, considering the length and depth of the cup as the legs of a right triangle. We also evaluated changes in Bruch's membrane opening-to-Bruch's membrane opening diameter. Statistical analysis was performed using generalized estimating equations. A total of 15 eyes were included. The mean patient age was 70 (SD, 11.04) years. The mean circumpapillary retinal nerve fiber layer was 60.13 (SD, 23.21) µm and the visual field mean deviation was -13.29 (SD, 8.5) dB. The mean intraocular pressure at each visit was: 20.5 (SD, 4.99); 11 (SD, 4.95) and 15.7 (SD, 5.04), respectively. The mean hypotenuse of the optic nerve head cup, the mean depth and length of the optic nerve head cup, and the Bruch's membrane opening-to-Bruch's membrane opening diameter decreased significantly after the intraocular pressure-lowering procedures. The hypotenuse of the optic nerve head cup evaluated with SS-OCT significantly decreased after intraocular pressure-lowering surgeries. This parameter was useful for evaluating short-term changes in the optic nerve head.