Skip to main content

Advertisement

SpringerLink
Log in

Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

A Correction to this article was published on 05 July 2018

This article has been updated

Abstract

Purpose

To report the impact of non-penetrating deep sclerectomy (NPDS) in severe and end-stage glaucoma treatment on the central 10° visual field progression (mean deviation, four central points, foveal threshold) and assess the risk of sudden visual loss.

Methods

Monocenter database study. We reviewed records of 34 eyes with severe or end-stage glaucoma that underwent NPDS between 2009 and 2015, at the National Ophthalmology Center of XV-XX (Paris, France). Severe and end-stage glaucoma were defined according to the Bascom Palmer Modified Glaucoma Staging System classification. All eyes had a constricted visual field < 10° (severe injury by the Humphrey visual field automated (HVFA) 10-2). Visual fields were recorded every 6 months after the procedure. Data from the last visit was used for the statistical analysis.

Results

The mean follow-up duration was 29 months (range 6 to 54) and 33 (97%) eyes were followed for more than 1 year. There were no cases of postoperative sudden visual loss. The intraocular pressure (IOP) decreased from 21.9 ± 8.1 to 15.0 ± 5.4 mmHg (P < .001). Twenty-eight (82%) eyes had an IOP < 21 mmHg and 19 (56%) an IOP < 16 mmHg. The MD 10-2 remained stable (− 19.8 ± 7.4 to − 19.4 ± 8.1 dB, non-significant improvement of + 0.4 dB, P = .1). The MD 10-2 slope showed an insignificant improvement of + 0.25 ± 1.8 dB per year (dB/y) (P = 0.1), but this slope was significantly better when the IOP was reduced to < 16 mmHg than when the IOP was ≥ 16 mmHg at the last visit (+ 0.84  1.2 versus − 0.48 ± 2.2 dB/y, P = .05). The mean number of the four central test points with sensitivity ≤ 5 dB and the change in mean sensitivity of the four central field points remained stable. There were no significant changes in the VFI (from 25.4% ± 13 to 25.8% ± 20) and in foveal threshold.

Conclusion

NPDS appears to provide stability of the central 10° visual field (with a trend towards improvement but non-significant) with no occurrence of “wipe-out” phenomenon and few other complications. Consideration of NPDS in end-stage and severe glaucoma is advisable given its low risk of complications and its considerable IOP decrease with a relative stability of the central visual field.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Change history

  • 05 July 2018

    The published online version contain mistake in the author list. The correct presentation is also given above.

Abbreviations

NPDS:

Non-penetrating deep sclerectomy

IOP:

Intraocular pressure

MD:

Mean deviation

VFI:

Visual function index

HVFA:

Humphrey visual field automated

References

  1. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 120(10):1268–1279

    Article  PubMed  Google Scholar 

  2. Collaborative Normal-Tension Glaucoma Study Group (1998) Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Am J Ophthalmol 126(4):487–497

    Article  Google Scholar 

  3. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA et al (2001) Interim clinical outcomes in the collaborative initial Glaucoma treatment study comparing initial treatment randomized to medications or surgery. Ophthalmology 108(11):1943–1953

    Article  CAS  PubMed  Google Scholar 

  4. The Advanced Glaucoma Intervention Study (AGIS): 7 (2000) The relationship between control of intraocular pressure and visual field deterioration. The AGIS investigators. Am J Ophthalmol 130(4):429–440

    Article  Google Scholar 

  5. Rao HL, Begum VU, Khadka D, Mandal AK, Senthil S, Garudadri CS (2015) Comparing glaucoma progression on 24-2 and 10-2 visual field examinations. PLoS One 10(5):e0127233

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Blumberg DM, De Moraes CG, Prager AJ, Yu Q, Al-Aswad L, Cioffi GA et al (2017) Association between undetected 10-2 visual field damage and vision-related quality of life in patients with glaucoma. JAMA Ophthalmol 135(7):742–747

    Article  PubMed  PubMed Central  Google Scholar 

  7. Aggarwal SP, Hendeles S (1986) Risk of sudden visual loss following trabeculectomy in advanced primary open-angle glaucoma. Br J Ophthalmol 70(2):97–99

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Costa VP, Smith M, Spaeth GL, Gandham S, Markovitz B (1993) Loss of visual acuity after trabeculectomy. Ophthalmology 100(5):599–612

    Article  CAS  PubMed  Google Scholar 

  9. Topouzis F, Tranos P, Koskosas A, Pappas T, Anastasopoulos E, Dimitrakos S et al (2005) Risk of sudden visual loss following filtration surgery in end-stage glaucoma. Am J Ophthalmol 140(4):661–666

    Article  PubMed  Google Scholar 

  10. Marques A (2014) Managing advanced unilateral pseudoexfoliative glaucoma. BMJ Case Rep. https://doi.org/10.1136/bcr-2014-204011

    Google Scholar 

  11. Ates H, Andac K, Uretmen O (1999) Non-penetrating deep sclerectomy and collagen implant surgery in glaucoma patients with advanced field loss. Int Ophthalmol 23(3):123–128

    Article  CAS  PubMed  Google Scholar 

  12. Gierek-Lapińska A, Leszczyński R, Wróbel A (2004) Non-penetrating deep sclerectomy in the treatment of advanced cases of open angle glaucoma. Klin Ocz 106(1–2 Suppl):168–169

    Google Scholar 

  13. Mills RP, Budenz DL, Lee PP, Noecker RJ, Walt JG, Siegartel LR et al (2006) Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease. Am J Ophthalmol 141(1):24–30

    Article  PubMed  Google Scholar 

  14. Law SK, Nguyen AM, Coleman AL, Caprioli J (2007) Severe loss of central vision in patients with advanced glaucoma undergoing trabeculectomy. Arch Ophthalmol 125(8):1044–1050

    Article  PubMed  Google Scholar 

  15. Rao HL, Raveendran S, James V, Dasari S, Palakurthy M, Reddy HB et al (2017) Comparing the performance of compass perimetry with Humphrey field analyzer in eyes with glaucoma. J Glaucoma 26(3):292–297

    Article  PubMed  Google Scholar 

  16. Bengtsson B, Heijl A (2000) False-negative responses in glaucoma perimetry: indicators of patient performance or test reliability? Invest Ophthalmol Vis Sci 41(8):2201–2204

    CAS  PubMed  Google Scholar 

  17. Katz J, Sommer A, Witt K (1991) Reliability of visual field results over repeated testing. Ophthalmology 98(1):70–75

    Article  CAS  PubMed  Google Scholar 

  18. Aptel F, Bron AM, Lachkar Y, Schweitzer C (2017) Change in visual field progression following treatment escalation in primary open-angle glaucoma. J Glaucoma 26(10):875–880

    Article  PubMed  Google Scholar 

  19. Zalta AH (1991) Use of a central 10 degrees field and size V stimulus to evaluate and monitor small central islands of vision in end stage glaucoma. Br J Ophthalmol 75(3):151–154

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Popovic V, Sjöstrand J (1991) Long-term outcome following trabeculectomy: II. Acta Ophthalmol 69(3):305–309

    Article  CAS  Google Scholar 

  21. Bhardwaj N, Niles PI, Greenfield DS, Hymowitz M, Sehi M, Feuer WJ et al (2013) The impact of surgical intraocular pressure reduction on visual function using various criteria to define visual field progression. J Glaucoma 22(8):632–637

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sponsel WE, Groth SL (2013) Mitomycin-augmented non-penetrating deep sclerectomy: preoperative gonioscopy and postoperative perimetric, tonometric and medication trends. Br J Ophthalmol 97(3):357–361

    Article  PubMed  Google Scholar 

  23. Gesser C, Wiermann A, Keserü M, Richard G, Klemm M (2014) Long-term follow-up after deep sclerectomy. Klin Monatsbl Augenheilkd 231(5):535–539

    Article  CAS  PubMed  Google Scholar 

  24. Carrillo MM, Artes PH, Nicolela MT, LeBlanc RP, Chauhan BC (2005) Effect of cataract extraction on the visual fields of patients with glaucoma. Arch Ophthalmol 123(7):929–932

    Article  PubMed  Google Scholar 

  25. Helmy H (2016) Phacoemulsification combined with deep sclerectomy augmented with mitomycin and amniotic membrane implantation in chronic primary open angle glaucoma with cataract. Electron Physician 8(4):2218–2226

    Article  PubMed  PubMed Central  Google Scholar 

  26. Chen PP, Budenz DL (1998) The effects of cataract extraction on the visual field of eyes with chronic open-angle glaucoma. Am J Ophthalmol 125(3):325–333

    Article  CAS  PubMed  Google Scholar 

  27. Moster MR, Moster ML (2005) Wipe-out: a complication of glaucoma surgery or just a blast from the past? Am J Ophthalmol 140(4):705–706

    Article  PubMed  Google Scholar 

  28. Fujishiro T, Mayama C, Aihara M, Tomidokoro A, Araie M (2011) Central 10-degree visual field change following trabeculectomy in advanced open-angle glaucoma. Eye 25(7):866–871

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kolker AE (1977) Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma. Trans Am Ophthalmol Soc 75:539–555

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Suominen SMA, Harju MP, Vesti ET (2016) Deep sclerectomy in primary open-angle glaucoma and exfoliative glaucoma. Eur J Ophthalmol 26(6):568–574

    Article  PubMed  Google Scholar 

  31. Moreno-López M, Pérez-Alvarez MJ (2006) Short- and medium-term intraocular pressure lowering effects of combined phacoemulsification and non-penetrating deep sclerectomy without scleral implant or antifibrotics. Arch Soc Esp Oftalmol 81(2):93–100

    Article  PubMed  Google Scholar 

  32. Ambresin A, Shaarawy T, Mermoud A (2002) Deep sclerectomy with collagen implant in one eye compared with trabeculectomy in the other eye of the same patient. J Glaucoma 11(3):214–220

    Article  PubMed  Google Scholar 

  33. Parrish RK, Feuer WJ, Schiffman JC, Lichter PR, Musch DC, CIGTS Optic Disc Study Group (2009) Five-year follow-up optic disc findings of the collaborative initial glaucoma treatment study. Am J Ophthalmol 147(4):717–724.e1

    Article  PubMed  PubMed Central  Google Scholar 

  34. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK, CIGTS Study Investigators (2009) Visual field progression in the Collaborative Initial Glaucoma Treatment Study the impact of treatment and other baseline factors. Ophthalmology 116(2):200–207

    Article  PubMed  Google Scholar 

  35. EGS Foundation (2014) European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Part 1, Savona, Italy

  36. Blumenthal EZ, Horani A, Sasikumar R, Garudadri C, Udaykumar A, Thomas R (2006) Correlating structure with function in end-stage glaucoma. Ophthalmic Surg Lasers Imaging 37(3):218–223

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre Hospitalier National d’Ophtalmologie des XV-XX, Service du Pr. NORDMANN, 28 rue de Charenton, 75012, Paris, France

    Igor Leleu, Benjamin Penaud, Esther Blumen-Ohana, Thibault Rodallec, Raphaël Adam, Olivier Laplace, Jad Akesbi & Jean-Philippe Nordmann

Authors
  1. Igor Leleu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Benjamin Penaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esther Blumen-Ohana
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thibault Rodallec
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raphaël Adam
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Olivier Laplace
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jad Akesbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jean-Philippe Nordmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Igor Leleu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

The original version of this article was revised: The published online version contain mistake in the author list (Incorrect order of first names and last names).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leleu, I., Penaud, B., Blumen-Ohana, E. et al. Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results. Graefes Arch Clin Exp Ophthalmol 256, 1489–1498 (2018). https://doi.org/10.1007/s00417-018-4025-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-018-4025-6

Keywords

Search

Navigation