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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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Related in: MedlinePlus

Effects of the digital ocular massage on filtering bleb morphology. Sixty seconds after bulbar digital massage of an eye implanted with Ex-PRESS (arrowhead), the fluid-filled cavity area extended posteriorly (asterisks), bleb-wall thickness increased, and several intraepithelial cysts appeared (arrows) compared to baseline (b and a, resp.) (RTVue, Optovue, Inc, CA).
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fig6: Effects of the digital ocular massage on filtering bleb morphology. Sixty seconds after bulbar digital massage of an eye implanted with Ex-PRESS (arrowhead), the fluid-filled cavity area extended posteriorly (asterisks), bleb-wall thickness increased, and several intraepithelial cysts appeared (arrows) compared to baseline (b and a, resp.) (RTVue, Optovue, Inc, CA).

Mentions: No previous studies were conducted on the application of AS-OCT for studying bleb modifications before and after bulbar massage. In a prospective case series study (unpublished data) conducted with SD-OCT (RTVue, Optovue, Inc., CA), we evaluated the modification of the fluid-filled cavity area, bleb-wall thickness, and scleral opening before and after bulbar digital massage (60 seconds of duration). We observed a significant decrease of IOP with an increase of the bleb-wall thickness, intraepithelial microcysts, and the fluid-filled cavity area more extended posteriorly (Figure 6). Of note, all these variables returned to baseline values after 120 minutes.


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)

Effects of the digital ocular massage on filtering bleb morphology. Sixty seconds after bulbar digital massage of an eye implanted with Ex-PRESS (arrowhead), the fluid-filled cavity area extended posteriorly (asterisks), bleb-wall thickness increased, and several intraepithelial cysts appeared (arrows) compared to baseline (b and a, resp.) (RTVue, Optovue, Inc, CA).
© Copyright Policy
Related In: Results  -  Collection

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

fig6: Effects of the digital ocular massage on filtering bleb morphology. Sixty seconds after bulbar digital massage of an eye implanted with Ex-PRESS (arrowhead), the fluid-filled cavity area extended posteriorly (asterisks), bleb-wall thickness increased, and several intraepithelial cysts appeared (arrows) compared to baseline (b and a, resp.) (RTVue, Optovue, Inc, CA).
Mentions: No previous studies were conducted on the application of AS-OCT for studying bleb modifications before and after bulbar massage. In a prospective case series study (unpublished data) conducted with SD-OCT (RTVue, Optovue, Inc., CA), we evaluated the modification of the fluid-filled cavity area, bleb-wall thickness, and scleral opening before and after bulbar digital massage (60 seconds of duration). We observed a significant decrease of IOP with an increase of the bleb-wall thickness, intraepithelial microcysts, and the fluid-filled cavity area more extended posteriorly (Figure 6). Of note, all these variables returned to baseline values after 120 minutes.

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