الفهرس 
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Abstract
SUMMARY
Glaucoma is defined as a set of optic neuropathies associated with optic nerve head structural changes which can lead to visual field loss and blindness. It can be classified into open angle and closed angle glaucoma according to the anterior chamber angle obstruction by apposition of the iris.
The current study was designed with an aim to evaluate the peripapillary nerve fiber layer thickness and macular perfusion after sub-scleral trabeculectomy with and without mitomycin by OCT and OCT angiography.
It was an interventional study conducted from May 2020 to end of December 2021 in the ophthalmology department at Beni-Suef University Hospital, on ninety-nine patients with glaucoma, participants were within three groups: (33 patients underwent sub-scleral trabeculectomy without use of antimetabolite, 33 patients underwent sub-scleral trabeculectomy with use of sub-scleral Mitomycin 0.02% and 33 patients underwent sub-scleral trabeculectomy with use of subconjunctival Mitomycin 0.02%) to assess peripapillary nerve fiber layer thickness and macular perfusion after sub-scleral trabeculectomy with and without mitomycin by OCT and OCT angiography.
The three techniques were effective in lowering IOP significantly, compared with preoperative levels, there was a statistically significant difference between the trabeculectomy alone and trabeculectomy +MMC groups, regarding the degree of decrease in IOP that was significantly lowest among trabeculectomy alone group (p-value =0.031, 0.042), there was non-statistically significant difference between group (B) and group (C) (sub-scleral or sub-conjunctival MMC), with regard to the mean decrease in IOP. Superior and Inferior RNFL were slightly decreased in all studied groups in post- as compared with pre-operative assessment, however this reduction was of non-statistically significant difference. The superficial and deep macular vessel densities were significantly increased in some (not all sectors), in pre- and post-assessment in the three studied groups, however the improvement in VD (%) was more among groups (B) and (C) as compared with group (A), (p-values <0.05).
Measurable changes occur in Vessel Density (%) but not in RNFL thickness after trabeculectomy as conducted by the three techniques (trabeculectomy, trabeculectomy +sub-scleral MMC and trabeculectomy+sub-conjunctival MMC).
Further studies with longer follow up period after surgery is recommended based on the results of the current study, as glaucoma is a progressive degenerative disease.