Progression of visual field defects and visual loss in trabeculectomized eyes
To evaluate progression of visual field (VF) defects and development of visual impairment (low vision and blindness) after trabeculectomy. We evaluated retrospectively 138 eyes of 138 consecutive patients over 40 years of age with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EG) opera...
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| creator | Ehrnrooth, Pia Puska, Päivi Lehto, Ilkka Laatikainen, Leila |
| description | To evaluate progression of visual field (VF) defects and development of visual impairment (low vision and blindness) after trabeculectomy.
We evaluated retrospectively 138 eyes of 138 consecutive patients over 40 years of age with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EG) operated on by trabeculectomy without antimetabolites. The mean follow-up period was 3.5 years (range 2-5). In 83 eyes, pre- and postoperative VF measured by the same technique were compared to detect progression. Visual acuities (VA) were recorded as Snellen decimal notations. VA of |
| doi_str_mv | 10.1007/s00417-004-1088-3 |
| format | Article |
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We evaluated retrospectively 138 eyes of 138 consecutive patients over 40 years of age with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EG) operated on by trabeculectomy without antimetabolites. The mean follow-up period was 3.5 years (range 2-5). In 83 eyes, pre- and postoperative VF measured by the same technique were compared to detect progression. Visual acuities (VA) were recorded as Snellen decimal notations. VA of <0.3 to 0.05 was defined as low vision and VA of <0.05 or VF constricted to less than 20 degrees in diameter as blindness.
In 34 (41%) of 83 eyes with comparable fields, VF defects progressed because of glaucoma. In logistic regression analysis, severity of preoperative VF loss (P=0.0047) and use of preoperative oral anti-glaucomatous medication (P=0.047) correlated significantly with VF progression. In univariate analysis, also initial intraocular pressure (IOP) reduction after surgery (P=0.023) and IOP reduction from preoperative to last postoperative examination (P=0.036) were significantly smaller in eyes with VF progression. Defect progression did not, however, correlate significantly with the last IOP (P=0.58). Six eyes (4.3%) were blind due to glaucoma preoperatively and 14 eyes (10.1%) at the last follow-up. Visual impairment correlated with the severity of initial VF loss (P=0.008).
Progression of VF defects and development of visual impairment due to glaucoma was fairly common despite trabeculectomy. Both were associated with severity of initial VF defect. In this series, no significant correlation appeared between defect progression and the last IOP, but association between stability of VF and the amount of IOP reduction after surgery indicate that a lower target IOP level particularly in eyes with initially severe VF defect would, however, be needed.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-004-1088-3</identifier><identifier>PMID: 15700183</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Adult ; Aged ; Blindness - etiology ; Blindness - physiopathology ; Disease Progression ; Female ; Glaucoma, Open-Angle - complications ; Glaucoma, Open-Angle - physiopathology ; Glaucoma, Open-Angle - surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Ophthalmology ; Retrospective Studies ; Trabeculectomy ; Vision, Low - etiology ; Vision, Low - physiopathology ; Visual Acuity ; Visual Field Tests ; Visual Fields</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2005-08, Vol.243 (8), p.741-747</ispartof><rights>Springer-Verlag 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-5ab23089234ad858d1127bed5f3ef02531168a3391530efc3735e0a0be23e1e23</citedby><cites>FETCH-LOGICAL-c326t-5ab23089234ad858d1127bed5f3ef02531168a3391530efc3735e0a0be23e1e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15700183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ehrnrooth, Pia</creatorcontrib><creatorcontrib>Puska, Päivi</creatorcontrib><creatorcontrib>Lehto, Ilkka</creatorcontrib><creatorcontrib>Laatikainen, Leila</creatorcontrib><title>Progression of visual field defects and visual loss in trabeculectomized eyes</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>To evaluate progression of visual field (VF) defects and development of visual impairment (low vision and blindness) after trabeculectomy.
We evaluated retrospectively 138 eyes of 138 consecutive patients over 40 years of age with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EG) operated on by trabeculectomy without antimetabolites. The mean follow-up period was 3.5 years (range 2-5). In 83 eyes, pre- and postoperative VF measured by the same technique were compared to detect progression. Visual acuities (VA) were recorded as Snellen decimal notations. VA of <0.3 to 0.05 was defined as low vision and VA of <0.05 or VF constricted to less than 20 degrees in diameter as blindness.
In 34 (41%) of 83 eyes with comparable fields, VF defects progressed because of glaucoma. In logistic regression analysis, severity of preoperative VF loss (P=0.0047) and use of preoperative oral anti-glaucomatous medication (P=0.047) correlated significantly with VF progression. In univariate analysis, also initial intraocular pressure (IOP) reduction after surgery (P=0.023) and IOP reduction from preoperative to last postoperative examination (P=0.036) were significantly smaller in eyes with VF progression. Defect progression did not, however, correlate significantly with the last IOP (P=0.58). Six eyes (4.3%) were blind due to glaucoma preoperatively and 14 eyes (10.1%) at the last follow-up. Visual impairment correlated with the severity of initial VF loss (P=0.008).
Progression of VF defects and development of visual impairment due to glaucoma was fairly common despite trabeculectomy. Both were associated with severity of initial VF defect. In this series, no significant correlation appeared between defect progression and the last IOP, but association between stability of VF and the amount of IOP reduction after surgery indicate that a lower target IOP level particularly in eyes with initially severe VF defect would, however, be needed.</description><subject>Adult</subject><subject>Aged</subject><subject>Blindness - etiology</subject><subject>Blindness - physiopathology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glaucoma, Open-Angle - complications</subject><subject>Glaucoma, Open-Angle - physiopathology</subject><subject>Glaucoma, Open-Angle - surgery</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Retrospective Studies</subject><subject>Trabeculectomy</subject><subject>Vision, Low - etiology</subject><subject>Vision, Low - physiopathology</subject><subject>Visual Acuity</subject><subject>Visual Field Tests</subject><subject>Visual Fields</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkE9Lw0AQxRdRbK1-AC8SPHiLzuxku9ujFP9BRQ8KvS2bZCIpaVJ3G6F-ere0Inh5c3i_Gd48Ic4RrhFA3wSADHUaNUUwJqUDMcSMVKpBzg_FELTE1JCcD8RJCAuIICk8FgNUGgANDcXzq-8-PIdQd23SVclXHXrXJFXNTZmUXHGxDolry1-j6UJI6jZZe5dz0TfR75b1N5cJbziciqPKNYHP9nMk3u_v3qaP6ezl4Wl6O0sLkuN1qlwuCcxEUuZKo0yJKHXOpaqIK5CKEMfGEU1QEXBVkCbF4CBnSYxRRuJqd3flu8-ew9ou61Bw07iWuz7YsVGUwVhH8PIfuOh638ZsNibQOsOJiRDuoMLH7zxXduXrpfMbi2C3Rdtd0Taq3RZtKe5c7A_3-ZLLv419s_QD0zl4Bg</recordid><startdate>200508</startdate><enddate>200508</enddate><creator>Ehrnrooth, Pia</creator><creator>Puska, Päivi</creator><creator>Lehto, Ilkka</creator><creator>Laatikainen, Leila</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200508</creationdate><title>Progression of visual field defects and visual loss in trabeculectomized eyes</title><author>Ehrnrooth, Pia ; Puska, Päivi ; Lehto, Ilkka ; Laatikainen, Leila</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-5ab23089234ad858d1127bed5f3ef02531168a3391530efc3735e0a0be23e1e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blindness - etiology</topic><topic>Blindness - physiopathology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glaucoma, Open-Angle - complications</topic><topic>Glaucoma, Open-Angle - physiopathology</topic><topic>Glaucoma, Open-Angle - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Retrospective Studies</topic><topic>Trabeculectomy</topic><topic>Vision, Low - etiology</topic><topic>Vision, Low - physiopathology</topic><topic>Visual Acuity</topic><topic>Visual Field Tests</topic><topic>Visual Fields</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ehrnrooth, Pia</creatorcontrib><creatorcontrib>Puska, Päivi</creatorcontrib><creatorcontrib>Lehto, Ilkka</creatorcontrib><creatorcontrib>Laatikainen, Leila</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ehrnrooth, Pia</au><au>Puska, Päivi</au><au>Lehto, Ilkka</au><au>Laatikainen, Leila</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progression of visual field defects and visual loss in trabeculectomized eyes</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2005-08</date><risdate>2005</risdate><volume>243</volume><issue>8</issue><spage>741</spage><epage>747</epage><pages>741-747</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>To evaluate progression of visual field (VF) defects and development of visual impairment (low vision and blindness) after trabeculectomy.
We evaluated retrospectively 138 eyes of 138 consecutive patients over 40 years of age with primary open-angle glaucoma (POAG) or exfoliation glaucoma (EG) operated on by trabeculectomy without antimetabolites. The mean follow-up period was 3.5 years (range 2-5). In 83 eyes, pre- and postoperative VF measured by the same technique were compared to detect progression. Visual acuities (VA) were recorded as Snellen decimal notations. VA of <0.3 to 0.05 was defined as low vision and VA of <0.05 or VF constricted to less than 20 degrees in diameter as blindness.
In 34 (41%) of 83 eyes with comparable fields, VF defects progressed because of glaucoma. In logistic regression analysis, severity of preoperative VF loss (P=0.0047) and use of preoperative oral anti-glaucomatous medication (P=0.047) correlated significantly with VF progression. In univariate analysis, also initial intraocular pressure (IOP) reduction after surgery (P=0.023) and IOP reduction from preoperative to last postoperative examination (P=0.036) were significantly smaller in eyes with VF progression. Defect progression did not, however, correlate significantly with the last IOP (P=0.58). Six eyes (4.3%) were blind due to glaucoma preoperatively and 14 eyes (10.1%) at the last follow-up. Visual impairment correlated with the severity of initial VF loss (P=0.008).
Progression of VF defects and development of visual impairment due to glaucoma was fairly common despite trabeculectomy. Both were associated with severity of initial VF defect. In this series, no significant correlation appeared between defect progression and the last IOP, but association between stability of VF and the amount of IOP reduction after surgery indicate that a lower target IOP level particularly in eyes with initially severe VF defect would, however, be needed.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>15700183</pmid><doi>10.1007/s00417-004-1088-3</doi><tpages>7</tpages></addata></record> |
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| ispartof | Graefe's archive for clinical and experimental ophthalmology, 2005-08, Vol.243 (8), p.741-747 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Blindness - etiology Blindness - physiopathology Disease Progression Female Glaucoma, Open-Angle - complications Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Humans Intraocular Pressure Male Middle Aged Ophthalmology Retrospective Studies Trabeculectomy Vision, Low - etiology Vision, Low - physiopathology Visual Acuity Visual Field Tests Visual Fields |
| title | Progression of visual field defects and visual loss in trabeculectomized eyes |
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