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Reversible structural and functional changes after intraocular pressure reduction in patients with glaucoma

  • Glaucoma
  • Published:
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Abstract

Purpose

The aim of this study was to evaluate structural and functional improvement following intraocular pressure (IOP) reduction in patients with glaucoma using Spectral Domain Optical Coherence Tomography (SD-OCT), Visual Field (VF) testing, and Visual Evoked Potentials (VEP).

Methods

A total of 76 eyes from 61 patients underwent SD-OCT, VF and VEP testing. Sixty-two eyes were put in either an acutely high (group 1, IOP > 32 mmHg) or mildly high (group 2, IOP between 22 and 31 mmHg) IOP group and underwent a pressure-lowering intervention. Fourteen eyes with stable glaucoma were controls (group 3, IOP < 22 mmHg). SD-OCT, VF and VEP testing were subsequently performed on all patients at three follow-up visits. Results from these follow-up periods were analyzed for signs of functional and structural improvement.

Results

Both group 1 and group 2 patients demonstrated significant decrease in the average cup to disc ratio (p < 0.05) following the intervention. Post-interventional reduction of cup volume was also significant for group 2 patients (p < 0.05). RNFL thickness changes were insignificant. Qualitative grading of VFs by two observers showed improvement in group 1 patients’ VFs (p = 0.021). VEP measurements were mostly insignificant, with the exception of High Contrast Latency (LHC) deteriorating for group 2 patients in the first follow-up visit (p = 0.025).

Conclusions

This study provides evidence for structural disc cupping reversal following IOP lowering interventions. These changes were not related to the amount of pressure lowering. While there was evidence of functional improvement as measured by VF testing, VEP was unable to detect any reversible changes.

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Authors and Affiliations

  1. Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, 19107, USA

    Michael Waisbourd, Osama M. Ahmed, Jeanne Molineaux, George L Spaeth & L. Jay Katz

  2. Diopsys Inc., Pine Brook, NJ, USA

    Alberto Gonzalez

Authors
  1. Michael Waisbourd
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  2. Osama M. Ahmed
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  3. Jeanne Molineaux
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  4. Alberto Gonzalez
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  5. George L Spaeth
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  6. L. Jay Katz
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Corresponding author

Correspondence to Michael Waisbourd.

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Funding

Allergan, Inc. provided financial support in the form of a research grant. The Glaucoma Service Foundation to Prevent Blindness, Philadelphia, PA, provided financial support in the form of travel support funding. Diopsys Inc., Pine Brook, NJ provided the visual evoked potential testing platform. The sponsor had no role in the design or conduct of this research.

Conflict of interest

Dr. L. Jay Katz is a consultant for Diopsys Inc. Drs. LJ Katz and Michael Waisbourd receive research support from Diopsys Inc. Dr. Alberto Gonzalez is an employee of Diopsys, Inc. Dr. George L. Spaeth, Mr. Osama Ahmed and Mrs. Jeanne Molineaux certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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.

Informed consent

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

Clinical Trial Registration Number: NCT02600403.

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Waisbourd, M., Ahmed, O.M., Molineaux, J. et al. Reversible structural and functional changes after intraocular pressure reduction in patients with glaucoma. Graefes Arch Clin Exp Ophthalmol 254, 1159–1166 (2016). https://doi.org/10.1007/s00417-016-3321-2

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  • DOI: https://doi.org/10.1007/s00417-016-3321-2

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