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KMID : 1813520220110010038
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Journal of the Korean Glaucoma Society
2022 Volume.11 No. 1 p.38 ~ p.48
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Comparison of Surgical Outcomes in Glaucomatous Eyes with or without Choroidal Microvascular Dropout and Analysis of Risk Factors Associated with Visual Field Progression after Trabeculectomy
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Baek Min-Su
Shin Joong-Won
Sung Kyung-Rim
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Abstract
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Purpose : To investigate surgical outcomes and risk factors related to visual field (VF) progression 1 year after trabeculectomy in primary open-angle glaucoma (POAG) eyes with or without choroidal microvasculature dropout (CMvD) primarily using optical coherence tomography angiography.
Methods : Eighty-five eyes of 85 POAG patients who underwent trabeculectomy were enrolled in this study (53 eyes with CMvD and 32 eyes without CMvD). The clinical characteristics were compared between POAG eyes with and without CMvD preoperatively and 1 year postoperatively. Putative factors associated with VF deterioration (reduction of mean deviation worse than 2 decibels after trabeculectomy) were evaluated using logistic regression analysis.
Results : Intraocular pressure was decreased from 19.9 ± 8.5 mmHg to 12.2 ± 3.5 mmHg at postoperative 1 year (p < 0.001). In eyes with CMvD, the peripapillary vessel density (VD) was lower, and the VF mean deviation (MD) and VF index (VFI) were worse at preoperative and postoperative 1 year after trabeculectomy compared to eyes without CMvD. In multivariate logistic regression, a greater reduction of peripapillary VD (odds ratio, 1.076; p = 0.046) was significantly associated with VF deterioration 1 year after trabeculectomy.
Conclusions : Compared to eyes without CMvD, in CMvD eyes, peripapillary VD was lower, and VF MD and VFI worsened preoperatively and postoperatively. The only risk factor related to VF deterioration after trabeculectomy was greater peripapillary VD reduction.
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KEYWORD
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Microvessels, Tomography, Optical coherence, Glaucoma, Open-angle, Trabeculectomy
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