Limits...
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.

Show MeSH

Related in: MedlinePlus

Functioning filtering blebs. Functioning blebs, after MMC-augmented trabeculectomy, present a diffuse (a) or a cystic shape (b) at clinical evaluation. At AS-OCT (Visante OCT) these blebs show a patent and low reflective inner cavity (asterisks) (c and d), multilobed in the cystic shape, and a thick and low reflective bleb wall. In vivo laser scanning confocal microscopy (e) shows numerous intraepithelial microcysts in a glaucomatous patient after successful MMC-augmented trabeculectomy (planar reconstruction of the superior bulbar conjunctiva 6 weeks after surgery). (e: from Ciancaglini et al., [15] with permission from the publisher).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4127298&req=5

fig2: Functioning filtering blebs. Functioning blebs, after MMC-augmented trabeculectomy, present a diffuse (a) or a cystic shape (b) at clinical evaluation. At AS-OCT (Visante OCT) these blebs show a patent and low reflective inner cavity (asterisks) (c and d), multilobed in the cystic shape, and a thick and low reflective bleb wall. In vivo laser scanning confocal microscopy (e) shows numerous intraepithelial microcysts in a glaucomatous patient after successful MMC-augmented trabeculectomy (planar reconstruction of the superior bulbar conjunctiva 6 weeks after surgery). (e: from Ciancaglini et al., [15] with permission from the publisher).

Mentions: Several studies have analyzed if TD-OCT (Visante OCT) can be used to distinguish between functioning and nonfunctioning filtering blebs [27, 28]. Leung et al. [27] differentiated blebs according to their global appearance: diffuse or cystic blebs were classified as functioning, whereas encapsulated or flattened blebs were classified as nonfunctioning. Additionally, while functioning blebs presented a low to medium reflectivity of the external wall with a wide inner fluid-filled cavity, failed blebs presented with opposite features (Figures 2 and 3). Pfenninger et al. [29] reported a significant direct correlation between the reflectivity of the fluid-filled cavity and the IOP, whereas Tominaga et al. [30] found a significant inverse correlation between the bleb-wall thickness and IOP. On the contrary, the same authors did not find significant correlation between the height and extent of the filtering bleb cavity and the IOP.


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)

Functioning filtering blebs. Functioning blebs, after MMC-augmented trabeculectomy, present a diffuse (a) or a cystic shape (b) at clinical evaluation. At AS-OCT (Visante OCT) these blebs show a patent and low reflective inner cavity (asterisks) (c and d), multilobed in the cystic shape, and a thick and low reflective bleb wall. In vivo laser scanning confocal microscopy (e) shows numerous intraepithelial microcysts in a glaucomatous patient after successful MMC-augmented trabeculectomy (planar reconstruction of the superior bulbar conjunctiva 6 weeks after surgery). (e: from Ciancaglini et al., [15] with permission from the publisher).
© Copyright Policy
Related In: Results  -  Collection

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

fig2: Functioning filtering blebs. Functioning blebs, after MMC-augmented trabeculectomy, present a diffuse (a) or a cystic shape (b) at clinical evaluation. At AS-OCT (Visante OCT) these blebs show a patent and low reflective inner cavity (asterisks) (c and d), multilobed in the cystic shape, and a thick and low reflective bleb wall. In vivo laser scanning confocal microscopy (e) shows numerous intraepithelial microcysts in a glaucomatous patient after successful MMC-augmented trabeculectomy (planar reconstruction of the superior bulbar conjunctiva 6 weeks after surgery). (e: from Ciancaglini et al., [15] with permission from the publisher).
Mentions: Several studies have analyzed if TD-OCT (Visante OCT) can be used to distinguish between functioning and nonfunctioning filtering blebs [27, 28]. Leung et al. [27] differentiated blebs according to their global appearance: diffuse or cystic blebs were classified as functioning, whereas encapsulated or flattened blebs were classified as nonfunctioning. Additionally, while functioning blebs presented a low to medium reflectivity of the external wall with a wide inner fluid-filled cavity, failed blebs presented with opposite features (Figures 2 and 3). Pfenninger et al. [29] reported a significant direct correlation between the reflectivity of the fluid-filled cavity and the IOP, whereas Tominaga et al. [30] found a significant inverse correlation between the bleb-wall thickness and IOP. On the contrary, the same authors did not find significant correlation between the height and extent of the filtering bleb cavity and the IOP.

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