Changes in choroidal area after intraocular pressure reduction following trabeculectomy. 2018

Hirokazu Kojima, and Kazuyuki Hirooka, and Eri Nitta, and Kaori Ukegawa, and Shozo Sonoda, and Taiji Sakamoto
Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, Japan.

To investigate changes of the macular and peripapillary choroidal areas after trabeculectomy. This prospective and interventional study examined 74 eyes of 74 patients with glaucoma uncontrolled by medical therapy. Enhanced depth imaging optical coherence tomography (EDI-OCT) recorded macular and peripapillary choroidal images at 1 day before trabeculectomy and at 2 weeks after surgery. The Niblack method was used to covert luminal and interstitial areas to binary images. At baseline, the mean intraocular pressure (IOP) was 17.6±6.3 mmHg, while it was 6.5±2.9 mmHg after trabeculectomy (P < 0.001). Increases were observed for the macular choroidal area after the surgery, with the total area increasing from 317,853±95,728 μm2 to 368,597±104,393 μm2, while the luminal area increased from 210,355±73,650 μm2 to 249,464±77,195 μm2, and the interstitial area increased from 107,498±27,613 μm2 to 119,133±31,811 μm2 (all P < 0.001). Increases were also observed after the surgery for the peripapillary choroidal area, with the total area increasing from 1,629,440±460,429 μm2 to 1,974,289±500,496 μm2, while the luminal area increased from 920,141±328,690 μm2 to 1,179,843±357,601 μm2, and the interstitial area increased from 709,299±153,179 μm2 to 794,446±169,029 μm2 (all P < 0.001). There was a significant increase in the ratio of the luminal to choroidal area in the macular area (67.2%) and in the peripapillary area (59.1%). Factors associated with the changes in the peripapillary choroidal area included decreases in the diastolic blood pressure and IOP. A reduction in the IOP after trabeculectomy led to increases in the macular and peripapillary choroidal areas. Observed changes in the choroidal area after trabeculectomy are primarily due to increases in the luminal areas.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D008266 Macula Lutea An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the posterior pole of the eye and slightly below the level of the optic disk. It is characterized by the presence of a yellow pigment diffusely permeating the inner layers, contains the fovea centralis in its center, and provides the best phototropic visual acuity. It is devoid of retinal blood vessels, except in its periphery, and receives nourishment from the choriocapillaris of the choroid. (From Cline et al., Dictionary of Visual Science, 4th ed) Lutea, Macula,Luteas, Macula,Macula Luteas
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002829 Choroid The thin, highly vascular membrane covering most of the posterior of the eye between the RETINA and SCLERA. Choriocapillaris,Haller Layer,Haller's Layer,Sattler Layer,Sattler's Layer,Choroids
D005260 Female Females
D005901 Glaucoma An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed) Glaucomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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