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

Filtering bleb morphology modifications after laser suture lysis (LSL). Nonfunctioning encapsulated filtering bleb (a) showing a subconjunctival fluid filled cavity isolated from the anterior chamber because of the tight contact of the flap with the surrounding sclera. After LSL the scleral flap appears separated from the surrounding sclera, with restoration of the access (asterisk) with the anterior chamber (b) (Visante OCT).
© Copyright Policy
Related In: Results  -  Collection

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

fig8: Filtering bleb morphology modifications after laser suture lysis (LSL). Nonfunctioning encapsulated filtering bleb (a) showing a subconjunctival fluid filled cavity isolated from the anterior chamber because of the tight contact of the flap with the surrounding sclera. After LSL the scleral flap appears separated from the surrounding sclera, with restoration of the access (asterisk) with the anterior chamber (b) (Visante OCT).

Mentions: Laser Suture Lysis (LSL). In a prospective observational case series study Singh et al. [42] reported that AS-OCT significantly affected the decision-making process concerning LSL after trabeculectomy. In this study, LSL was recommended in 100.0% of cases based on clinical findings of elevated IOP, deep AC, and a poorly formed bleb. When AS-OCT was used to decide whether to perform LSL or not, this procedure was recommended in 71.4% of cases, particularly in blebs showing opposed scleral flaps, absent subflap spaces, and thin bleb wall. Moreover, AS-OCT can also be used to assess bleb modifications after LSL. In successful treatments, a separation of the scleral flap from the scleral bed is evident (Figure 8), with facilitation of the AH drainage and the elevation of the conjunctiva at the site of bleb [43, 44].


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)

Filtering bleb morphology modifications after laser suture lysis (LSL). Nonfunctioning encapsulated filtering bleb (a) showing a subconjunctival fluid filled cavity isolated from the anterior chamber because of the tight contact of the flap with the surrounding sclera. After LSL the scleral flap appears separated from the surrounding sclera, with restoration of the access (asterisk) with the anterior chamber (b) (Visante OCT).
© Copyright Policy
Related In: Results  -  Collection

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

fig8: Filtering bleb morphology modifications after laser suture lysis (LSL). Nonfunctioning encapsulated filtering bleb (a) showing a subconjunctival fluid filled cavity isolated from the anterior chamber because of the tight contact of the flap with the surrounding sclera. After LSL the scleral flap appears separated from the surrounding sclera, with restoration of the access (asterisk) with the anterior chamber (b) (Visante OCT).
Mentions: Laser Suture Lysis (LSL). In a prospective observational case series study Singh et al. [42] reported that AS-OCT significantly affected the decision-making process concerning LSL after trabeculectomy. In this study, LSL was recommended in 100.0% of cases based on clinical findings of elevated IOP, deep AC, and a poorly formed bleb. When AS-OCT was used to decide whether to perform LSL or not, this procedure was recommended in 71.4% of cases, particularly in blebs showing opposed scleral flaps, absent subflap spaces, and thin bleb wall. Moreover, AS-OCT can also be used to assess bleb modifications after LSL. In successful treatments, a separation of the scleral flap from the scleral bed is evident (Figure 8), with facilitation of the AH drainage and the elevation of the conjunctiva at the site of bleb [43, 44].

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