Relationship between preoperative high intraocular pressure and retinal nerve fibre layer thinning after glaucoma surgery

Sci Rep. 2019 Sep 25;9(1):13901. doi: 10.1038/s41598-019-50406-7.

Abstract

Recent reports show varying results regarding peripapillary retinal nerve fibre layer (RNFL) thickness after intraocular pressure (IOP)-lowering glaucoma surgery. We hypothesised that different levels of the preoperative IOP influence RNFL thickness. A total of 60 patients (60 eyes) with glaucoma, who underwent glaucoma surgery and had a stable postoperative mean IOP < 22 mmHg, were enrolled. The RNFL thickness was measured using spectral domain optical coherence tomography, before and at 3-6 months after surgery. The preoperative peak IOP, 37.4 ± 10.8 mmHg, decreased to a postoperative mean IOP of 14.8 ± 3.5 mmHg (p < 0.001). The average RNFL thickness was significantly reduced from 75.6 ± 17.7 μm to 70.2 ± 15.8 μm (p < 0.001). In subgroup analyses, only patients with a preoperative peak IOP ≥ median value (37 mmHg) exhibited significant RNFL thinning (9.7 ± 6.6 μm, p < 0.001) associated with a higher preoperative peak IOP (r = 0.475, p = 0.008). The RNFL thinning was evident for a few months after glaucoma surgery in patients with a higher preoperative peak IOP, although the postoperative IOP was stable.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Glaucoma / physiopathology*
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Nerve Fibers / physiology*
  • Ophthalmologic Surgical Procedures / methods
  • Optic Disk / physiopathology
  • Optic Disk / surgery
  • Optic Nerve Diseases / physiopathology
  • Optic Nerve Diseases / surgery
  • Retina / physiology*
  • Retina / surgery
  • Retrospective Studies
  • Visual Fields / physiology
  • Young Adult