Association Between Structure-function Characteristics and Visual Field Outcomes in Glaucoma Subjects With Intraocular Pressure Reduction After Trabeculectomy. Issue 8 (August 2020) - Kadziauskienė, Aistė
Abstract : Precis: Improvements in post-trabeculectomy visual field (VF) outcomes were found to be significantly associated with preoperative nerve fiber layer thickness parameters extracted from the sectorized structure-function relationship, baseline VF, and severity of glaucoma. Objective: To determine whether the preoperative structure-function relationship helps to predict visual outcomes at 1-year post-trabeculectomy. Patients and Methods: In total, 91 eyes from 87 participants who successfully underwent trabeculectomy were included in our study. All eyes received optical coherence tomography imaging and VF assessment using 30-2 standard automated perimetry preoperatively at baseline and postoperatively 1 year after trabeculectomy. The linear mixed-model analysis was used to assess the association of structure and function at baseline, and multivariate analysis to investigate factors associated with postoperative VF outcomes. Results: Results from multivariate and univariate analysis for VF 1 year after trabeculectomy showed that a positive preoperative retinal nerve fiber layer thickness deviation from the structure-function model was found to be significantly associated with improved postoperative VF outcomes [β=0.06 dB/μm; 95% confidence interval (CI), 0.03-0.09]. Other significant factors included baseline VF MD (β=−0.18; 95% CI, −0.23 to −0.13) and the presence of severe glaucoma (β=−1.69; 95% CI, −2.80 to −0.57). Intraocular pressure was positively associated with improved VF outcomes only in univariate analysis (β=0.06; 95% CI, 0.01-0.11). Conclusions and Relevance: Characteristics derived from the baseline structure-function relationship were found to be strongly associated with postoperative VF outcomes. These findings suggest that the structure-function relationship could potentially have a role in predicting VF progression after trabeculectomy. Abstract : Supplemental Digital Content is available in the text.