Photo Credit: RobertoDavid

The following is a summary of “Structural reversal of disc cupping measured in Bruch’s membrane opening-based OCT morphometry after PRESERFLO microshunt implantation for open-angle glaucoma,” published in the January 2025 issue of Ophthalmology by Lüke et al. 

Researchers conducted a retrospective study to analyze the longitudinal changes in Bruch’s membrane opening minimal rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (pRNFL) thickness using optical coherence tomography (OCT) following PRESERFLO® microshunt implantation for surgical glaucoma management in adult patients with glaucoma.   

They analyzed data from 59 eyes of 59 participants who underwent PRESERFLO® microshunt implantation between 2019 and 2022 at a tertiary glaucoma center. The surgical procedure included primary temporary occlusion of the glaucoma shunt to prevent early hypotony. Pre- and post-operative OCT assessments of the optic nerve head (ONH) and intraocular pressure (IOP) were conducted. Longitudinal changes in morphometric spectral-domain OCT parameters of the ONH were correlated with variations in IOP.  

The results showed that BMO-MRW increased from baseline (BL = 171.15 ± 66.80 μm) to 3 months post-surgery (FU = 180.78 ± 70.394 μm, P = 0.034). Preoperative IOP (24.97 ± 7.22 mmHg) decreased to 13.70 ± 5.09 mmHg after surgery. After 18 months, BMO-MRW showed no significant change (BL = 169.83 ± 52.69 μm; FU = 164.98 ± 55.85 μm, P = 0.271), with mean IOP at 13.08 ± 4.48 mmHg. A significant correlation between IOP reduction and BMO-MRW change (r = 0.453, P < 0.05) was noted at 3 months. Peripapillary RNFL thickness remained unchanged at 3 months (P > 0.16) but significantly decreased later (P = 0.009).  

Investigators concluded the PRESERFLO® microshunt implantation with primary temporary occlusion resulted in a significant, albeit transient, increase in BMO-MRW, a phenomenon known as structural reversal of disc cupping (SRDC), which appeared less pronounced and shorter in duration compared to trabeculectomy with similar IOP outcomes. 

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03838-3