The British journal of ophthalmology · 2026
Risk factors for postoperative structural reversal of disc cupping in Bruch membrane opening-based morphometry of the optic nerve head for glaucoma.
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Steinberg Florian Thomas, Schiller Petra, Gietzelt Caroline, Kiessling David, Lüke Jan Niklas, Heindl Ludwig M, Dietlein Thomas S, Enders Philip
Аннотация
PURPOSE: To identify risk factors for changes in Bruch's membrane opening-based optical coherence tomography (OCT) parameters after glaucoma surgery and to evaluate duration and dynamics of structural reversal of disc cupping (SRDC) in three different types of glaucoma surgery.
DESIGN: Retrospective, interventional case series.
METHODS: Evaluation of 151 eyes of 151 patients who received trabeculectomy, ab-interno trabeculotomy or glaucoma drainage device (GDD) surgery. Dynamics of postoperative change in Bruch membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fibre layer thickness in spectral-domain OCT were assessed. Multiple linear regression models identified risk factors for occurrence and magnitude of SRDC.
RESULTS: Compared with baseline, BMO-MRW increased significantly up to the 9-month follow-up (p=0.048) after surgery. A multiple regression model for all patients showed a high relative reduction in intraocular pressure (IOP) (standard β=-0.272, p<0.001), an early date of follow-up (stand β=-0.280, p<0.001) and GDD as surgical procedure (standard β=0.169, p=0.027) as significant risk factors for SRDC.Within the first 9 months after intervention, a low postoperative IOP (standard β=-0.469, p<0.001), a young age (standard β=-0.423, p<0.001) and a short axial length (standard β=-0.235, p=0.040) had a significant impact on the BMO-MRW increase.
CONCLUSION: In this set of patients with glaucoma undergoing different types of IOP-lowering surgery, significant SRDC was seen up to 9 months postoperatively. Risk factors for the extent of SRDC were younger age at surgery, early hypotonia or low postoperative IOP and hyperopia.
DESIGN: Retrospective, interventional case series.
METHODS: Evaluation of 151 eyes of 151 patients who received trabeculectomy, ab-interno trabeculotomy or glaucoma drainage device (GDD) surgery. Dynamics of postoperative change in Bruch membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fibre layer thickness in spectral-domain OCT were assessed. Multiple linear regression models identified risk factors for occurrence and magnitude of SRDC.
RESULTS: Compared with baseline, BMO-MRW increased significantly up to the 9-month follow-up (p=0.048) after surgery. A multiple regression model for all patients showed a high relative reduction in intraocular pressure (IOP) (standard β=-0.272, p<0.001), an early date of follow-up (stand β=-0.280, p<0.001) and GDD as surgical procedure (standard β=0.169, p=0.027) as significant risk factors for SRDC.Within the first 9 months after intervention, a low postoperative IOP (standard β=-0.469, p<0.001), a young age (standard β=-0.423, p<0.001) and a short axial length (standard β=-0.235, p=0.040) had a significant impact on the BMO-MRW increase.
CONCLUSION: In this set of patients with glaucoma undergoing different types of IOP-lowering surgery, significant SRDC was seen up to 9 months postoperatively. Risk factors for the extent of SRDC were younger age at surgery, early hypotonia or low postoperative IOP and hyperopia.