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목적 : To evaluate peripapillary microvascular changes in patients with primary open-angle glaucoma (POAG) after trabeculectomy using optical coherence tomography (OCT) angiography, and to determine the influence of reversing lamina cribrosa (LC) displacement on changes in peripapillary microvasculature.
방법 : The peripapillary retinal microvasculature and LC were imaged using OCT angiography and OCT-enhanced depth imaging, respectively. The microvasculature and LC depth (LCD) were measured before, and 1 week, 1 month, and 3 months after trabeculectomy. The microvascular improvement was arbitrarily defined as a reduction > 30% of the area of vascular dropout (blue/black areas with < 20% vessel density on the color-coded vessel density map). LCD was determined as the distance between the anterior LC surface and a reference line connecting the 2 terminations of Bruch’s membrane.
결과 : At 3 months’ postoperatively, IOP and LCD were significantly decreased from 27.4±12.7 mmHg to 13.7±3.9 mmHg, and 520.6±154.9 μm to 471.8±135.1 μm, respectively (p=0.002 and 0.024), compared with baseline. The microvascular improvement was observed in 15 eyes (68.2%) 3 months after trabeculectomy. The maximal reductions in IOP and LCD were significantly greater in eyes with improved microvasculature compared to eyes without improvement (p=0.037 and p=0.003). The microvascular improvement was significantly associated with maximal reduction of LCD (p=0.030).
결론 : Trabeculectomy can improve peripapillary retinal microvasculature in patients with POAG. This finding suggests that the reduction of LCD induced by lowering IOP may induce peripapillary microvascular improvement in eyes with POAG.
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