Short-term Change of Optic Nerve Head Topography after Trabeculectomy in Adult Glaucoma Patients as Measured by Heidelberg Retina Tomograph

Using the Heidelberg Retina Tomograph (HRT, Heidelberg Engineering, Heidelberg, Germany) we investigated whether reversal of glaucomatous optic disc cupping occurs in adult glaucoma patients following intraocular pressure (IOP) reduction by trabeculectomy, and whether topographic change in the optic disc differs according to region. Thirteen eyes of 13 glaucoma patients in whom IOP reduction was 25% or more at postoperative follow-up of 2 months were enrolled in the study. Cup/disc area ratio had decreased significantly, while rim area and rim volume showed significant increases (p < 0.05, Wilcoxon signed rank test). Among the optic disc sectors, rim area in the superior and inferior quadrants, especially in the superotemporal and inferotemporal octant, had increased significantly. The decrease in maximum cup depth correlated significantly with the percent IOP reduction (r = 0.698, p = 0.016). Reversal of glaucomatous optic disc cupping after IOP reduction following trabeculectomy in adult patients was confirmed by HRT. Furthermore, the regions of selective reversal in the superior and inferior quadrants coincided with those parts of the optic nerve head in which early functional and structural glaucomatous damage has been known to occur.