Effect of SLT Location on Treatment Outcomes

Study Overview
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Brief Summary
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Selective Laser Trabeculoplasty (SLT) is a glaucoma treatment that has been shown to effectively lower intraocular pressure by increasing aqueous outflow through macrophage recruitment. There is evidence of increased drainage in the nasal quadrants of the eye. This study aims to compare whether there is a difference in the reduction of eye pressure when SLT is performed nasally and temporally.

Detailed Description
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This study aims to evaluate if there is a difference between 180 degree nasal and temporal selective laser trabeculoplasty (SLT) in treatment outcomes. It is known that there is increased aqueous collectors and veins and thus aqueous drainage in the nasal quadrants of the eye. If SLT works by the hypothesized biologic mechanism in which macrophages remodel the aqueous drainage system to increase outflow, performing SLT in an area concentrated with aqueous veins may increase outflow more. As a result, we hypothesize that nasal 180 degree SLT may have better outcomes compared to the temporal counterpart. The results of this study may help inform decisions when performing 180 degree SLT and provide insight to SLT's mechanism of action. The primary objective of this study is to determine if there is a difference in treatment efficacy between nasal and temporal 180 degree SLT by measuring differences in baseline and post-operative intraocular pressures. We hypothesize that nasal SLT will have superior outcomes compared to temporal SLT due to increased number of aqueous veins.

Official Title
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Effect of 180 Degree Selective Laser Trabeculoplasty Location on Treatment Outcomes

Conditions
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Glaucoma

Intervention / Treatment
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* Procedure: Selective Laser Trabeculoplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of open angle glaucoma, ocular hypertension, pigmentary dispersion syndrome and pseudoexfoliation syndrome Participant must be over 18 years of age IOP > 16mmHg on at least two consecutive occasions separated by one month Two sighted eyes with visual acuity of 20/200 or better Informed consent from patient Exclusion Criteria: Diagnosis of secondary OAG (aside from pigmentary and pseudoexfoliation glaucoma) or narrow angle glaucoma Previous incisional glaucoma surgery Incisional glaucoma surgery scheduled within 1 year of intervention Corneal disease affecting visualization of anterior chamber of the eye Treatment or plan to treat with topical or systemic steroids Previous selective laser trabeculoplasty treatment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Nasal SLT<br>This cohort will have 180 degree SLT completed on the nasal quadrants of the trabecular meshwork. | Procedure: Selective Laser Trabeculoplasty<br>* Laser treatment for glaucoma.<br>|
| Temporal SLT<br>This cohort will have 180 degree SLT completed on the temporal quadrants of the trabecular meshwork. | Procedure: Selective Laser Trabeculoplasty<br>* Laser treatment for glaucoma.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraocular Pressure | The primary outcome in this study is the change in intraocular pressure from baseline to the 1 year follow-up visit (continuous variable). The percentage decrease in IOP from baseline will also be calculated and compared between the two groups. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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selective laser trabeculoplasty, practice, treatment, intraocular pressure