J Korean Ophthalmol Soc.  2010 Feb;51(2):234-240. 10.3341/jkos.2010.51.2.234.

The Morphometric Analysis of Filtering Bleb Using Anterior Segment Optical Coherence Tomography: Pilot Study

Affiliations
  • 1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. kcyeye@yuhs.ac
  • 2Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To evaluate intrableb morphology and function after trabeculectomy using anterior segment optical coherence tomography (AS-OCT).
METHODS
Twenty-eight post-trabeculectomy eyes from patients with primary open-angle glaucoma were examined using AS-OCT. Intrableb structures, including bleb wall thickness, subconjunctival fluid, suprascleral fluid and the route under the scleral flap, were measured at the center of the bleb using AS-OCT and were classified according to their slit-lamp appearance. Blebs were classified as successful (IOP< or =18 mmHg without ocular hypotensive medication) and failed (IOP>18 mmHg or use of ocular hypertensive medication.) in order to compare parameters between the two groups.
RESULTS
The blebs were classified as either diffuse filtering (n=17), cystic (n=5), encapsulated (n=3) or flattened (n=3) according to slit lamp appearance and were correlated with AS-OCT images. Blebs were classified as successful and failed in order to compare parameters between the two groups. Significant differences were observed between the two groups in regard to subconjunctival fluid space (p=0.0004). No significant differences were observed in bleb wall thickness (p=0.098), suprascleral fluid space (p=0.87) or the route under the scleral flap (p=0.196).
CONCLUSIONS
AS-OCT images of the intrableb structures were correlated with the appearance of the slit lamp, and a large subconjunctival space was associated with good bleb function. AS-OCT is useful for evaluating blebs; further studies should be performed to verify these findings.

Keyword

Anterior segment OCT; Bleb function; Intrableb morphology

MeSH Terms

Blister
Eye
Glaucoma, Open-Angle
Humans
Pilot Projects
Tomography, Optical Coherence
Trabeculectomy

Figure

  • Figure 1. Morphology of bleb using Visante TM OCT. BW=bleb wall thickness; SF=subconjunctival fluid; SS=scle-rotomy site; SF=scleral flap; R=route under scleral flap; SSF=suprascleral fluid.

  • Figure 2. AS-OCT image and corresponding slit-lamp appearance. (A) Diffuse functioning bleb. (B) Cystic bleb. (C) Encapsulated bleb. (D) Flattened bleb


Cited by  1 articles

Bleb Morphology of Fornix-Based Versus Limbus-Based Conjunctival Flaps in Trabeculectomy with Mitomycin C
Byeong Hee Lee, Won Suk Choi, Jong Wook Lee, Kyoo Won Lee
J Korean Ophthalmol Soc. 2011;52(12):1461-1469.    doi: 10.3341/jkos.2011.52.12.1461.


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