Reversal of Optic Disc Cupping in Adults with Advanced Glaucoma

ABSTRACT

Several studies have reported that the extent of cupping reversal after reduction of intraocular pressure may decrease with the progression of glaucomatous optic nerve damage. Three cases of reversal of glaucomatous cupping occurred after mitomycin C trabeculectomy in 20 and 22-year-old patients with advanced open angle glaucoma. The magnitude of intraocular pressure reduction was 35 to 38mmHg(average 36.7mmHg), a 79.1% drop from initial pressures. An improvement in the visual field occurred in one eye after re versa 1 of cupping. The most likely mechanism to explain reversal of cupping is a reduction in the posterior bowing of the lamina cribrosa. Even in the advan ced stage of glaucoma, reversal of cupping may be possible in young adults, as seen in our cases.