Long-Term Follow-Up After Successful Trabeculectomy: A Case Report of Reversal of Cupping and Recovery of Visual Field Progression.
adult
glaucoma
reversal of cupping
trabeculectomy
visual field recovery
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
23 Feb 2021
23 Feb 2021
Historique:
entrez:
31
3
2021
pubmed:
1
4
2021
medline:
1
4
2021
Statut:
epublish
Résumé
Glaucoma is one of the leading causes of blindness worldwide, and reduction of intraocular pressure (IOP) is the only available evidence-based treatment that reduces visual field deterioration in glaucoma. We present a representative case of structural recovery and recovery of visual field progression after successful trabeculectomy (TLE) with long-term follow-up. A 35-year-old woman with glaucoma visited our hospital in 2008. The IOP in her right eye was 11 mmHg at the first visit, and subsequently increased to values in the high teens to 20 mmHg despite treatment with anti-glaucoma eye drops. During this period, the progression of this eye's visual field deterioration was fast (mean deviation [MD] slope = -0.63 dB/year) and the optic disc cupping was advanced. In the seven-year period after successful TLE in 2014, the IOP declined to between 8 and 12 mmHg without any anti-glaucoma medication. During the first two years after TLE, the MD values were poorer than those before TLE. However, by 2020, MD values improved gradually to a state better than that before the surgery (MD slope during this period was +0.75 dB/year). The appearance of the optic disc was monitored using fundus photography, which showed optic disc morphological changes during topical glaucoma medication before and after TLE. In particular, a remarkable reversal of optic disc cupping enlargement started at two weeks after TLE, and the optic disc shape in 2021 was similar to that in 2008. Minimally invasive glaucoma surgeries are often preferred; however, our findings suggest that successful TLE followed by long-term rigorous IOP control can result in structural recoveries. Additionally, despite the deterioration in visual field in the early years after TLE, in the long term, it may settle down to the same level before the surgery with recovery of visual field progression, which may be a part of functional recovery.
Identifiants
pubmed: 33786227
doi: 10.7759/cureus.13520
pmc: PMC7994084
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e13520Informations de copyright
Copyright © 2021, Nakakura et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Invest Ophthalmol Vis Sci. 2013 Aug 09;54(8):5392-9
pubmed: 23838772
Br J Ophthalmol. 2020 Jan;104(1):81-86
pubmed: 31055450
Exp Eye Res. 2011 Aug;93(2):133-40
pubmed: 20708001
Sci Rep. 2020 Feb 18;10(1):2808
pubmed: 32071369
PLoS One. 2017 Oct 4;12(10):e0185246
pubmed: 28977004
Ophthalmology. 2013 Mar;120(3):553-559
pubmed: 23218823
Jpn J Ophthalmol. 2021 Jan;65(1):6-22
pubmed: 33150512
Graefes Arch Clin Exp Ophthalmol. 2010 Nov;248(11):1671-3
pubmed: 20532551
Surv Ophthalmol. 2021 Sep-Oct;66(5):714-742
pubmed: 32998003
Surv Ophthalmol. 2021 Jan - Feb;66(1):109-123
pubmed: 32450159
Bull Soc Belge Ophtalmol. 2010;(316):49-57
pubmed: 21305812
Graefes Arch Clin Exp Ophthalmol. 2018 Dec;256(12):2391-2398
pubmed: 30251201
Ophthalmology. 2018 Nov;125(11):1729-1740
pubmed: 29961552
Ophthalmology. 2016 Jan;123(1):117-28
pubmed: 26602970
Am J Ophthalmol. 2018 Oct;194:143-152
pubmed: 30053469
Transl Vis Sci Technol. 2020 Apr 23;9(5):15
pubmed: 32821487
Ophthalmol Glaucoma. 2020 Jan-Feb;3(1):32-39
pubmed: 32632405
Am J Ophthalmol. 2009 Apr;147(4):717-724.e1
pubmed: 19152871