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Anterior segment optical coherence tomography imaging of conjunctival filtering blebs after glaucoma surgery.

Mastropasqua R, Fasanella V, Agnifili L, Curcio C, Ciancaglini M, Mastropasqua L - Biomed Res Int (2014)

Bottom Line: In patients undergoing surgery, AS-OCT is crucial in the evaluation of the filtering bleb functionality, permitting a combined qualitative and quantitative analysis.In this field, AS-OCT may help clinicians in distinguishing between functioning and nonfunctioning blebs by classifying their macroscopic morphology, describing bleb-wall features, bleb cavity, and scleral opening.This information is critical in recognizing signs of filtration failure earlier than the clinical approach and in planning the appropriate timing for management procedures in failing blebs.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, 53593 Verona, Italy.

ABSTRACT
Time domain (TD) and spectral domain (SD) optical coherence tomography (OCT) are cross-sectional, noncontact, high-resolution diagnostic modalities for posterior and anterior segment (AS) imaging. The AS-OCT provides tomographic imaging of the cornea, iris, lens, and anterior chamber (AC) angle in several ophthalmic diseases. In glaucoma, AS-OCT is utilized to evaluate the morphology of AS structures involved in the pathogenesis of the disease, to obtain morphometric measures of the AC, to evaluate the suitability for laser or surgical approaches, and to assess modifications after treatment. In patients undergoing surgery, AS-OCT is crucial in the evaluation of the filtering bleb functionality, permitting a combined qualitative and quantitative analysis. In this field, AS-OCT may help clinicians in distinguishing between functioning and nonfunctioning blebs by classifying their macroscopic morphology, describing bleb-wall features, bleb cavity, and scleral opening. This information is critical in recognizing signs of filtration failure earlier than the clinical approach and in planning the appropriate timing for management procedures in failing blebs. In this review, we summarize the applications of AS-OCT in the conjunctival bleb assessment.

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Spectral domain- (SD-) and time domain- (TD-) OCT assessment of a cystic filtering bleb. Slit-lamp biomicroscopy of a functioning cystic bleb after Ex-PRESS implant (a and b). Bleb images (taken at the same point) as obtained with SD-OCT (Optovue and Spectralis, resp.) (c and d) and TD-OCT (Visante OCT) (e). SD-OCT presents a higher resolution with a more detailed visualization of bleb-wall layers, inner cystic spaces, and the limit between scleral bed and bleb, with respect to TD-OCT. On the other hand, SD platforms seem to have less tissue penetration than TD- OCT (arrows).
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fig1: Spectral domain- (SD-) and time domain- (TD-) OCT assessment of a cystic filtering bleb. Slit-lamp biomicroscopy of a functioning cystic bleb after Ex-PRESS implant (a and b). Bleb images (taken at the same point) as obtained with SD-OCT (Optovue and Spectralis, resp.) (c and d) and TD-OCT (Visante OCT) (e). SD-OCT presents a higher resolution with a more detailed visualization of bleb-wall layers, inner cystic spaces, and the limit between scleral bed and bleb, with respect to TD-OCT. On the other hand, SD platforms seem to have less tissue penetration than TD- OCT (arrows).

Mentions: On the other hand, the optical cross-sections obtained with SD-OCT have less tissue penetration than TD-OCT. Therefore, while SD-OCT is able to show features of the bleb wall such as the optically empty cystic spaces and scarring processes, this imaging technique is less adapt in imaging deep structures such as the scleral flap, intrascleral lake, and internal ostium [18] (Figure 1).


Anterior segment optical coherence tomography imaging of conjunctival filtering blebs after glaucoma surgery.

Mastropasqua R, Fasanella V, Agnifili L, Curcio C, Ciancaglini M, Mastropasqua L - Biomed Res Int (2014)

Spectral domain- (SD-) and time domain- (TD-) OCT assessment of a cystic filtering bleb. Slit-lamp biomicroscopy of a functioning cystic bleb after Ex-PRESS implant (a and b). Bleb images (taken at the same point) as obtained with SD-OCT (Optovue and Spectralis, resp.) (c and d) and TD-OCT (Visante OCT) (e). SD-OCT presents a higher resolution with a more detailed visualization of bleb-wall layers, inner cystic spaces, and the limit between scleral bed and bleb, with respect to TD-OCT. On the other hand, SD platforms seem to have less tissue penetration than TD- OCT (arrows).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127298&req=5

fig1: Spectral domain- (SD-) and time domain- (TD-) OCT assessment of a cystic filtering bleb. Slit-lamp biomicroscopy of a functioning cystic bleb after Ex-PRESS implant (a and b). Bleb images (taken at the same point) as obtained with SD-OCT (Optovue and Spectralis, resp.) (c and d) and TD-OCT (Visante OCT) (e). SD-OCT presents a higher resolution with a more detailed visualization of bleb-wall layers, inner cystic spaces, and the limit between scleral bed and bleb, with respect to TD-OCT. On the other hand, SD platforms seem to have less tissue penetration than TD- OCT (arrows).
Mentions: On the other hand, the optical cross-sections obtained with SD-OCT have less tissue penetration than TD-OCT. Therefore, while SD-OCT is able to show features of the bleb wall such as the optically empty cystic spaces and scarring processes, this imaging technique is less adapt in imaging deep structures such as the scleral flap, intrascleral lake, and internal ostium [18] (Figure 1).

Bottom Line: In patients undergoing surgery, AS-OCT is crucial in the evaluation of the filtering bleb functionality, permitting a combined qualitative and quantitative analysis.In this field, AS-OCT may help clinicians in distinguishing between functioning and nonfunctioning blebs by classifying their macroscopic morphology, describing bleb-wall features, bleb cavity, and scleral opening.This information is critical in recognizing signs of filtration failure earlier than the clinical approach and in planning the appropriate timing for management procedures in failing blebs.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, 53593 Verona, Italy.

ABSTRACT
Time domain (TD) and spectral domain (SD) optical coherence tomography (OCT) are cross-sectional, noncontact, high-resolution diagnostic modalities for posterior and anterior segment (AS) imaging. The AS-OCT provides tomographic imaging of the cornea, iris, lens, and anterior chamber (AC) angle in several ophthalmic diseases. In glaucoma, AS-OCT is utilized to evaluate the morphology of AS structures involved in the pathogenesis of the disease, to obtain morphometric measures of the AC, to evaluate the suitability for laser or surgical approaches, and to assess modifications after treatment. In patients undergoing surgery, AS-OCT is crucial in the evaluation of the filtering bleb functionality, permitting a combined qualitative and quantitative analysis. In this field, AS-OCT may help clinicians in distinguishing between functioning and nonfunctioning blebs by classifying their macroscopic morphology, describing bleb-wall features, bleb cavity, and scleral opening. This information is critical in recognizing signs of filtration failure earlier than the clinical approach and in planning the appropriate timing for management procedures in failing blebs. In this review, we summarize the applications of AS-OCT in the conjunctival bleb assessment.

Show MeSH
Related in: MedlinePlus