Changes in choroidal thickness after intraocular pressure reduction following trabeculectomy

Area of Science:

• Ophthalmology
• Glaucoma Research
• Choroidal Imaging

Background:

• Trabeculectomy is a surgical procedure to reduce intraocular pressure (IOP) in glaucoma patients.
• Changes in choroidal thickness (CT) following glaucoma surgery are not fully understood.
• Assessing these changes is crucial for understanding the ocular response to IOP reduction.

Purpose of the Study:

• To evaluate the impact of trabeculectomy on peripapillary and subfoveal choroidal thickness (CT).
• To analyze the correlation between changes in CT, intraocular pressure (IOP), and axial length post-surgery.

Main Methods:

• A prospective longitudinal study involving 37 eyes of open-angle glaucoma patients.
• Enhanced depth imaging spectral domain optical coherence tomography (EDI-SD-OCT) was used to measure CT.
• Measurements were taken pre-operatively and at 1 week, 3 months, and 6 months post-operatively.

Main Results:

• Subfoveal CT significantly increased 1 week post-trabeculectomy and remained elevated at 6 months (p < 0.001).
• Peripapillary CT also increased in all quadrants post-surgery (p < 0.05).
• Choroidal thickening correlated with greater IOP reduction and axial length shortening.

Conclusions:

• Trabeculectomy leads to a significant increase in both subfoveal and peripapillary CT, lasting at least 6 months.
• The observed choroidal thickening is associated with IOP reduction and axial length changes.
• Long-term, axial length decrease, rather than IOP, is the primary factor associated with peripapillary CT increase.