Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg.
We examined the effectiveness of trabeculectomy in decreasing the slope of mean deviation (MD) in Japanese patients with progressive normal-tension glaucoma (NTG) at low intraocular pressure (IOP) levels. The charts of patients who had undergone initial trabeculectomy with adjunctive mitomycin C for...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5574552?pdf=render |
| _version_ | 1818668433237082112 |
|---|---|
| author | Tomoko Naito Miyuki Fujiwara Takako Miki Ryoichi Araki Atsushi Fujiwara Yusuke Shiode Yuki Morizane Mikio Nagayama Fumio Shiraga |
| author_facet | Tomoko Naito Miyuki Fujiwara Takako Miki Ryoichi Araki Atsushi Fujiwara Yusuke Shiode Yuki Morizane Mikio Nagayama Fumio Shiraga |
| author_sort | Tomoko Naito |
| collection | DOAJ |
| description | We examined the effectiveness of trabeculectomy in decreasing the slope of mean deviation (MD) in Japanese patients with progressive normal-tension glaucoma (NTG) at low intraocular pressure (IOP) levels. The charts of patients who had undergone initial trabeculectomy with adjunctive mitomycin C for progressive NTG with medically controlled IOP < 15 mmHg in 2010-2013 were retrospectively reviewed. Seventeen eyes of 13 NTG patients who had undergone at least 5 times of visual field (VF) examinations in both of preoperatively and postoperatively with postoperative follow-up of ≥ 2 years were enrolled. Preoperative and postoperative MD slopes were compared to evaluate the effectiveness of trabeculectomy in slowing progression of VF. Mean IOP (8.1 ± 2.9 mmHg) and number of IOP-lowering medications (0.8 ± 1.5) were significantly lower postoperatively than preoperatively (13.9 ± 0.9 mmHg; P < 0.001 and 3.0± 0.4; P < 0.0001). In total, 91.7% of eyes with single-digit IOP postoperatively showed improvement in MD slope, whereas only 20.0% of eyes with IOP ≥ 10 mmHg postoperatively showed the improvement. Three eyes (17.6%) showed a decrease in visual acuity (VA) of ≥ 0.1 unit; this group had a lower mean postoperative IOP (6.0 ± 1.0 vs. 8.6 ± 3.0 mmHg; P = 0.1717) and a higher mean IOP reduction rate (56.2 vs. 38.5%; P = 0.8296) than eyes with a VA decrease of < 0.1 unit or no change. Thus, in this analysis of Japanese NTG patients with medically controlled IOP < 15 mmHg, achieving an IOP < 10 mmHg with trabeculectomy was beneficial for reducing the VF progression rate in progressive NTG at low IOP levels. However, an IOP < 7 mmHg by surgery would be required careful attention to VA decline. |
| first_indexed | 2024-12-17T06:36:14Z |
| format | Article |
| id | doaj.art-8d02138f02c84d81bf6482811e71a80c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T06:36:14Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-8d02138f02c84d81bf6482811e71a80c2022-12-21T22:00:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018409610.1371/journal.pone.0184096Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg.Tomoko NaitoMiyuki FujiwaraTakako MikiRyoichi ArakiAtsushi FujiwaraYusuke ShiodeYuki MorizaneMikio NagayamaFumio ShiragaWe examined the effectiveness of trabeculectomy in decreasing the slope of mean deviation (MD) in Japanese patients with progressive normal-tension glaucoma (NTG) at low intraocular pressure (IOP) levels. The charts of patients who had undergone initial trabeculectomy with adjunctive mitomycin C for progressive NTG with medically controlled IOP < 15 mmHg in 2010-2013 were retrospectively reviewed. Seventeen eyes of 13 NTG patients who had undergone at least 5 times of visual field (VF) examinations in both of preoperatively and postoperatively with postoperative follow-up of ≥ 2 years were enrolled. Preoperative and postoperative MD slopes were compared to evaluate the effectiveness of trabeculectomy in slowing progression of VF. Mean IOP (8.1 ± 2.9 mmHg) and number of IOP-lowering medications (0.8 ± 1.5) were significantly lower postoperatively than preoperatively (13.9 ± 0.9 mmHg; P < 0.001 and 3.0± 0.4; P < 0.0001). In total, 91.7% of eyes with single-digit IOP postoperatively showed improvement in MD slope, whereas only 20.0% of eyes with IOP ≥ 10 mmHg postoperatively showed the improvement. Three eyes (17.6%) showed a decrease in visual acuity (VA) of ≥ 0.1 unit; this group had a lower mean postoperative IOP (6.0 ± 1.0 vs. 8.6 ± 3.0 mmHg; P = 0.1717) and a higher mean IOP reduction rate (56.2 vs. 38.5%; P = 0.8296) than eyes with a VA decrease of < 0.1 unit or no change. Thus, in this analysis of Japanese NTG patients with medically controlled IOP < 15 mmHg, achieving an IOP < 10 mmHg with trabeculectomy was beneficial for reducing the VF progression rate in progressive NTG at low IOP levels. However, an IOP < 7 mmHg by surgery would be required careful attention to VA decline.http://europepmc.org/articles/PMC5574552?pdf=render |
| spellingShingle | Tomoko Naito Miyuki Fujiwara Takako Miki Ryoichi Araki Atsushi Fujiwara Yusuke Shiode Yuki Morizane Mikio Nagayama Fumio Shiraga Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. PLoS ONE |
| title | Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. |
| title_full | Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. |
| title_fullStr | Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. |
| title_full_unstemmed | Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. |
| title_short | Effect of trabeculectomy on visual field progression in Japanese progressive normal-tension glaucoma with intraocular pressure < 15 mmHg. |
| title_sort | effect of trabeculectomy on visual field progression in japanese progressive normal tension glaucoma with intraocular pressure 15 mmhg |
| url | http://europepmc.org/articles/PMC5574552?pdf=render |
| work_keys_str_mv | AT tomokonaito effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT miyukifujiwara effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT takakomiki effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT ryoichiaraki effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT atsushifujiwara effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT yusukeshiode effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT yukimorizane effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT mikionagayama effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg AT fumioshiraga effectoftrabeculectomyonvisualfieldprogressioninjapaneseprogressivenormaltensionglaucomawithintraocularpressure15mmhg |