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Long-term Longitudinal Changes in Choroidal Thickness with Intraocular Pressure Reduction after Glaucoma Surgery
녹내장수술 후 안압하강에 따른 맥락막두께의 장기 변화
JKOS 2020 Jan;61(1):69-77
Published online January 15, 2020;  https://doi.org/10.3341/jkos.2020.61.1.69
Copyright © 2020 The Korean Ophthalmological Society.
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Inhye Kim, MD1, Won Mo Gu, MD2, Areum Jeong, MD1, Soon Cheol Cha, MD, PhD1
김인혜1 · 구원모2 · 정아름1 · 차순철1

Department of Ophthalmology, Yeungnam University College of Medicine1, Daegu, Korea
Daegu Premier Eye Center2, Daegu, Korea
영남대학교 의과대학 안과학교실1, 잘보는안과의원2
Received May 16, 2019; Revised July 23, 2019; Accepted December 30, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: We investigated the long-term longitudinal changes in axial length (AL), mean ocular perfusion pressure (MOPP), and choroidal thickness (CT) according to the reduction of intraocular pressure (IOP) after glaucoma surgery. The potential variables associated with CT changes were also evaluated.
Methods: This was a prospective study for 1 year after glaucoma surgery, which included 71 eyes of 71 patients with primary open-angle glaucoma. The subfoveal CT (SFCT) and peripapillary CT (PPCT) were measured using spectral-domain optical coherence tomography preoperatively and 1 week, 1 month, 2 months, 6 months, and 1 year postoperatively. MOPP was calculated from the IOP and blood pressure. The AL was measured using partial coherence interferometry. Regression analysis was conducted to assess the possible association of variables.
Results: The AL decreased and the MOPP, SFCT, and PPCT increased significantly with IOP reduction at 1 year postoperatively (all, p < 0.001). The changes in SFCT and PPCT were significantly associated with IOP reduction at 1 year postoperatively (r = -0.519 and r = -0.528, respectively). Importantly, greater increases in SFCT and PPCT were found in patients with IOP reduction more than 30% from baseline, when compared with those with less than 30% reduction (p = 0.001 and p = 0.002, respectively). The SFCT increased more significantly in patients with AL ≤ 24 mm, compared with patients with AL > 24 mm (p = 0.044).
Conclusions: Reduction in the IOP, increase in the MOPP, decrease in the AL, and increase in the CT after glaucoma surgery persisted for 1 year during a long-term follow-up. These results suggested that glaucoma surgery reduced mechanical compression on the optic nerve fiber and increased intraocular blood flow.
Keywords : Axial length, Choroidal thickness, Glaucoma surgery, Intraocular pressure, Ocular perfusion pressure

 

February 2020, 61 (2)