Clinical Report: OCT Shows Slowing of Structural Glaucoma Progression After SLT
Overview
A retrospective study presented at the 2026 ARVO annual meeting indicates that selective laser trabeculoplasty (SLT) is associated with a significant slowing of structural glaucoma progression as measured by optical coherence tomography (OCT). The findings suggest that SLT may provide benefits beyond intraocular pressure reduction.
Background
Glaucoma management often focuses on lowering intraocular pressure (IOP), but understanding the structural progression of the disease is crucial for long-term patient outcomes. Selective laser trabeculoplasty (SLT) has gained popularity as a first-line treatment following the LiGHT trial, which demonstrated its efficacy. This study aims to clarify the impact of SLT on structural changes in glaucoma patients, an area that remains less defined.
Data Highlights
Parameter
Before SLT
After SLT
Average RNFL Thickness
Progressive thinning
No significant change
Superior RNFL Thickness
Progressive thinning
No significant change
Inferior RNFL Thickness
Progressive thinning
No significant change
Cup-to-Disc Ratio
Progressive change
No significant change
Mean IOP
Baseline
Statistically significant reduction
Key Findings
SLT is associated with a significant slowing of structural glaucoma progression as measured by OCT.
Prior to SLT, average, superior, and inferior RNFL thickness showed significant progressive thinning.
After SLT, rates of change for all evaluated OCT parameters were no longer significantly different from zero.
There was a modest but statistically significant reduction in mean IOP following SLT.
These findings support the use of SLT as a meaningful therapeutic option for preserving optic nerve health.
Clinical Implications
The results underscore the importance of considering SLT not only for IOP control but also for its potential to slow structural progression in glaucoma patients. This may influence treatment decisions and patient counseling regarding expected outcomes.
Conclusion
The study provides clinically relevant evidence that SLT may offer benefits beyond IOP reduction, potentially preserving optic nerve structure over time. These findings reinforce the role of SLT in glaucoma management.
