Reversibility of Optic Disc Cupping after Trabeculectomy in Adult Glaucoma Patients Measured by Heidelberg Retina Tomograph

Park, Ki Ho; Kim, Dong Myung; Youn, Dong Ho

Abstract

Using Heidelberg Retina Tomograph (HRT, Heidelberg Engineering, Heidelberg, Germany) we investigated whether reversal of glaucomatous optic disc cupping occurs in adult glaucoma patients following intraocular pressure (IOP) reduction by trabeculectomy, and whether there is any regional difference in topographic change of optic disc. Thirteen eyes of 13 glaucoma patients in whom the percent IOP reduction was 25% or more at postoperative follow-up of 2 months, were enrolled. Cup-to-disc area ratio was decreased significantly, while rim area and rim volume were increased significantly(p<0.05, Wilcoxon signed rank test) at postoperative follow-up of 2 months. Among the optic disc sectors, rim area in superior and inferior quadrant, especially in superotemporal and inferotemporal octant, increased significantly. Decrease in maximum cup depth correlated significantly with the percent IOP reduction (r=0.698, p=0.016). Reversal of glaucomatous optic disc cupping after IOP reduction following trabeculectomy in adult patients was confirmed by HRT, Furthermore, the regions of selective reversal in superior and inferior quadrant coincide with the well-known portion of early functional and structural glaucomatous optic nerve head damage.