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Ophthalmology Management

Article | 2026 ARVO

OCT Shows Slowing of Structural Glaucoma Progression After SLT 

“Results suggest that SLT may help slow progression of glaucomatous damage over time,” said Raeesah Ahsan, BA, in her presentation.  

By: Julie Greenbaum, editor
Ophthalmology Management May 6, 2026

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

ParameterBefore SLTAfter SLT
Average RNFL ThicknessProgressive thinningNo significant change
Superior RNFL ThicknessProgressive thinningNo significant change
Inferior RNFL ThicknessProgressive thinningNo significant change
Cup-to-Disc RatioProgressive changeNo significant change
Mean IOPBaselineStatistically 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.

References

  1. Ophthalmology Management, 2024 -- New Analysis of LiGHT Finds SLT Significantly Slows Glaucoma Progression Compared to Drops
  2. Glaucoma Physician, 2023 -- Six-year Results from LiGHT Trial Confirm SLT's Safety, Efficacy
  3. Glaucoma Physician, 2025 -- Reevaluating SLT: Updated Evidence and Clinical Pearls
  4. Glaucoma Physician, 2025 -- Six-year LiGHT Data Reviewed at AGS
  5. Primary Open-Angle Glaucoma Preferred Practice Pattern® - PubMed, 2024
  6. LiGHT trial: 6-year results of primary selective laser trabeculoplasty versus eye drops for the treatment of glaucoma and ocular hypertension - UCL Discovery
  7. Longitudinal evaluation of optical coherence tomography parameters for detecting glaucoma progression across disease severities | BMC Ophthalmology
  8. Primary Open-Angle Glaucoma Preferred Practice Pattern® - PubMed
  9. LiGHT trial: 6-year results of primary selective laser trabeculoplasty versus eye drops for the treatment of glaucoma and ocular hypertension - UCL Discovery
  10. Longitudinal evaluation of optical coherence tomography parameters for detecting glaucoma progression across disease severities | BMC Ophthalmology | Springer Nature Link