关键词: 青光眼/外科学, 小梁切除术, 青光眼性视神经损害, 图像配准

Abstract: Objective To study the changes of early optic disc morphological following trabeculectomy in adults. Design Retrospective case series. Participants Fifty-seven eyes out of 57 glaucoma patients aged 47.5±18.5 years old who were performed trabeculectomy in Beijing Institute of Ophthalmology from June 2010 to October 2011. Methods Patients who underwent trabeculectomy by the same surgeon were continuously selected from Tongren Eye Electronic Medical Record System. The inclusion criteria was that intraocular pressure was fully controlled after operation, and fundus photographs were available both pre- and post-operation. The two photographs were compared after being matched and flickered with a specific computer software. Qualitative analysis of optic disc and posterior pole fundus was performed. Main Outcome Measures Morphological changes of optic disc in fundus images. Results Reversal of optic cup after trabeculectomy were observed in 43 eyes (75.4%), and obviously reversal was observed in 30 eyes (52.6%). The mean age of participants with or without reversal of optic cup area was 43.7±18.7, or 59.7±13.6 years, respectively (t=-3.0,  P=0.009). Chronic glaucoma was major (95.3%) in patients with reversal of optic disc cupping. Location changes (mainly shift to the concentric) of optic disc vessels were found in 43 eyes (75.4%), which is significantly correlated with the presence of optic disc cupping reversal (r=0.775, P=0.000). Changes in optic disc and para-disc vessel diameter (29 eyes, 50.9%), and the occurence of macular edema (13 eyes, 22.8%) were also noticed. Conclusion Reversal of optic disc cup and the changes in optic disc vessel diameter and location are common in adults early after trabeculectomy, especially in younger patients. (Ophthalmol CHN, 2012, 21: 34-38)

Key words: glaucoma/surgery, trabeculectomy, glaucomatous optic neuropathy, image matching