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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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Filtering bleb morphology after biodegradable collagen matrix implantation. Three months after the subconjunctival implantation of the Ologen (a), no significant morphological differences in the macroscopic bleb structure are evident (except for a thicker bleb wall) compared to eyes that did not receive the implant (b).
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fig9: Filtering bleb morphology after biodegradable collagen matrix implantation. Three months after the subconjunctival implantation of the Ologen (a), no significant morphological differences in the macroscopic bleb structure are evident (except for a thicker bleb wall) compared to eyes that did not receive the implant (b).

Mentions: To date, their utility is still controversial [45, 46]. In a prospective randomized trial Cillino et al. [47] compared the Ologen implant as adjuvant versus low-dosage MMC in trabeculectomy and used AS SD-OCT (Topcon 3DOCT-1000, Topcon Corporation, Tokyo, Japan) to evaluate bleb morphology. The authors reported that SD-OCT did not show qualitative differences in the bleb-wall appearance between groups, indicating that the Ologen implant did not enhance or modify the morphology of the bleb wall. Nevertheless, SD-OCT documented a thicker bleb wall in successful Ologen-augmented trabeculectomy with respect to MMC-augmented successful trabeculectomy. In consistence with these results, in our case series (unpublished data) Optovue did not document significant differences of bleb morphology in patients implanted with Ologen compared to patients who did not receive the device (Figure 9).


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 after biodegradable collagen matrix implantation. Three months after the subconjunctival implantation of the Ologen (a), no significant morphological differences in the macroscopic bleb structure are evident (except for a thicker bleb wall) compared to eyes that did not receive the implant (b).
© Copyright Policy
Related In: Results  -  Collection

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

fig9: Filtering bleb morphology after biodegradable collagen matrix implantation. Three months after the subconjunctival implantation of the Ologen (a), no significant morphological differences in the macroscopic bleb structure are evident (except for a thicker bleb wall) compared to eyes that did not receive the implant (b).
Mentions: To date, their utility is still controversial [45, 46]. In a prospective randomized trial Cillino et al. [47] compared the Ologen implant as adjuvant versus low-dosage MMC in trabeculectomy and used AS SD-OCT (Topcon 3DOCT-1000, Topcon Corporation, Tokyo, Japan) to evaluate bleb morphology. The authors reported that SD-OCT did not show qualitative differences in the bleb-wall appearance between groups, indicating that the Ologen implant did not enhance or modify the morphology of the bleb wall. Nevertheless, SD-OCT documented a thicker bleb wall in successful Ologen-augmented trabeculectomy with respect to MMC-augmented successful trabeculectomy. In consistence with these results, in our case series (unpublished data) Optovue did not document significant differences of bleb morphology in patients implanted with Ologen compared to patients who did not receive the device (Figure 9).

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