CHANGES IN RETINAL NERVE FIBER LAYER THICKNESS ON HEIDELBERG RETINAL TOMOGRAPHY IN PATIENTS OF PRIMARY OPEN ANGLE GLAUCOMA AFTER TRABECULECTOMY VERSUS ANTI GLAUCOMA MEDICATION

• Main Authors: Asima Rafique, Asad Aslam Khan, Muhammad Shaheer
• Format: Article
• Language: English
• Published: Khyber Medical University 2020-09-01
• Series: Khyber Medical University Journal
• Subjects: retina; glaucoma, open-angle; trabeculectomy; nerve fibers; heidelberg retinal tomography
• Online Access: https://www.kmuj.kmu.edu.pk/article/view/20062
• ISSN: 2305-2643; 2305-2651

OBJECTIVE: To compare the retinal nerve fiber layer (RNFL) thickness changes in patients of primary open-angle glaucoma after trabeculectomy versus anti-glaucoma medication. METHODS: This quasi-experimental study was conducted from 10th February, 2017 to 28th February, 2018 on 60 patients presenting to the Institute of Ophthalmology, Mayo Hospital, Lahore, Pakistan using non-probability consecutive sampling. Patients were assigned to two equal groups: group A (n=30) patients underwent trabeculectomy while group B (n=30) patients were put on anti-glaucoma medication. Pre-treatment and three months post-treatment RNFL thickness was recorded and then analyzed using SPPSv.18.0. RESULTS: Out of 60 patients, Group A (n=30) had 14 (46.71%) males and 16 (53.31%) females, while Group B (n=30) had 16 (53.31%) males and 14 (46.71%) females. The mean age was 55.901±4.221 and 55.431±3.971 years in Group A and Group B respectively (p=0.661). In age group, 16 (53.31%) each in Group A and Group B were <55 years. Hypertensive status showed 9 (30.01%) and 5 (16.71%) hypertensive patients in Group A and Group B respectively. Mean change in RNFL thickness was 0.028±0.012μ and 0.013±0.007μ in Group A and Group B respectively (p=<0.001). Pre and post-treatment (pre:post) RNFL thickness (μ) in males, females, hypertensive, non-hypertensive, age <55 years, and age ≥55 years was 0.201±0.175μ:0.226±0.155, 0.205±0.159:0.233±0.019, 0.193±0.015:0.223±0.013, 0.206±0.015:0.233±0.018, 0.208±0.015:0.232±0.021, and 0.196±0.016:0.228±0.015 for Group A and 0.211±0.018:0.224±0.019, 0.201±0.015:0.215±0.014, 0.214±0.015:0.226±0.016, 0.205±0.018:0.218±0.017, 0.206±0.017:0.219±0.015, and 0.209±0.019:0.221±0.020 for group B respectively. CONCLUSION: Trabeculectomy increases thickness of retinal nerve fiber layer more than anti glaucoma medication.