Qian Liu1, Murtaza Saifee2, Yinxi Yu3, Gui-Shuang Ying3, Shuning Li4, Hua Zhong5, Steven J Gedde6, Ying Han7. 1. Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital and Zhengzhou University People's Hospital, Zhengzhou, People's Republic of China. 2. Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA. 3. Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA. 4. Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, People's Republic of China. 5. Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China. 6. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA. 7. Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA. Electronic address: ying.han@ucsf.edu.
Abstract
PURPOSE: To determine the change in global and regional Humphrey visual field (VF) after glaucoma drainage device (GDD) implantation over 3-year follow-up. DESIGN: Retrospective interventional case series METHODS: Patients undergoing GDD placement from 2010-2015 with reliable preoperative and yearly postoperative VF measurements were included. Clinical parameters were compared between preoperative and follow-up visits, including visual acuity, intraocular pressure (IOP), number of glaucoma medications, global VF metrics (mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) score on total deviation probability (CIGTS_TDP) and pattern deviation probability (CIGTS_PDP)), and regional metrics (regional total deviation (TD), regional pattern deviation (PD), and regional CIGTS_TDP and CIGTS_PDP). Multivariate regression analyses were performed to determine risk factors for VF worsening after GDD surgery. RESULTS: A total of 106 eyes from 95 patients were included. IOP (mean±standard deviation) was reduced from 23.1±8.5 mmHg to 12.7±3.1 mmHg at 3-year follow-up (P<0.001). MD, PSD and global CIGTS_PDP showed no significant changes in follow-up, whereas global CIGTS_TDP showed mild progression from 10.7 to 12.8 at 3-year follow-up (p = 0.01). No regional metrics showed worsening in follow-up. Defects in the superior hemifield was more common than in inferior hemifield at baseline and follow-ups for all regional metrics. Pre-operative number of glaucoma medications was associated with worsening on CIGTS_TDP. CONCLUSION: Overall, GDD surgery is effective at stabilizing VF function over 3-years of follow-up. The superior hemifield is affected more compared to the other regions. The number of pre-operative glaucoma medications is associated with mild VF progression measured by CIGTS_TDP.
PURPOSE: To determine the change in global and regional Humphrey visual field (VF) after glaucoma drainage device (GDD) implantation over 3-year follow-up. DESIGN: Retrospective interventional case series METHODS:Patients undergoing GDD placement from 2010-2015 with reliable preoperative and yearly postoperative VF measurements were included. Clinical parameters were compared between preoperative and follow-up visits, including visual acuity, intraocular pressure (IOP), number of glaucoma medications, global VF metrics (mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) score on total deviation probability (CIGTS_TDP) and pattern deviation probability (CIGTS_PDP)), and regional metrics (regional total deviation (TD), regional pattern deviation (PD), and regional CIGTS_TDP and CIGTS_PDP). Multivariate regression analyses were performed to determine risk factors for VF worsening after GDD surgery. RESULTS: A total of 106 eyes from 95 patients were included. IOP (mean±standard deviation) was reduced from 23.1±8.5 mmHg to 12.7±3.1 mmHg at 3-year follow-up (P<0.001). MD, PSD and global CIGTS_PDP showed no significant changes in follow-up, whereas global CIGTS_TDP showed mild progression from 10.7 to 12.8 at 3-year follow-up (p = 0.01). No regional metrics showed worsening in follow-up. Defects in the superior hemifield was more common than in inferior hemifield at baseline and follow-ups for all regional metrics. Pre-operative number of glaucoma medications was associated with worsening on CIGTS_TDP. CONCLUSION: Overall, GDD surgery is effective at stabilizing VF function over 3-years of follow-up. The superior hemifield is affected more compared to the other regions. The number of pre-operative glaucoma medications is associated with mild VF progression measured by CIGTS_TDP.
Authors: Marcus L Turner; Abu M Taha; Sean Yonamine; Yinxi Yu; Murtaza Saifee; Mike Yang; Gui-Shuang Ying; Ying Han; Julius T Oatts Journal: Clin Ophthalmol Date: 2022-09-29