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