High-definition imaging of trabeculectomy blebs using spectral domain optical coherence tomography adapted for the anterior segment

Mandeep Singh, Jovina L S See, Maria C. Aquino, Lennard S Y Thean, Paul T K Chew

Research output: Contribution to journalArticle

Abstract

Background: The aim of this work was to image trabeculectomy blebs using spectral domain optical coherence tomography (SDOCT). Methods: In this prospective cross-sectional study, patients who had undergone trabeculectomy with at least 3 months of follow up were included. Blebs were imaged using an adapted SDOCT system (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA) and time domain anterior segment optical coherence tomography (ASOCT) (Visante OCT, Carl Zeiss Meditec Inc.). An observer masked to clinical data assessed the utility of SDOCT and ASOCT in visualizing structures in successful and failed blebs. Results: Fifty-one eyes were imaged, of which 43 (84.3%) were successful. SDOCT showed wall thickening (93.0% vs. 67.4%, P = 0.006) and discrete hyporeflective spaces in the wall (88.4% vs. 14.0%, P <0.0001) in a greater proportion of successful blebs than ASOCT. SDOCT showed the bleb cavity (23.3% vs. 48.8%, P = 0.02), scleral flap (34.9% vs. 90.7%, P <0.0001), subflap space (20.9% vs. 72.1%, P <0.0001) and ostium (9.3% vs. 88.4%, P <0.0001) in fewer successful blebs than ASOCT. The internal ostium was not visualized in any failed bleb using SDOCT, whereas ASOCT showed the ostium in 87.5% of failed blebs (P = 0.001). SDOCT showed cystic spaces in the bleb wall in a greater proportion of successful blebs than failed blebs (88.4% vs. 37.5%, P = 0.005). Conclusions: SDOCT imaging was able to show fine superficial features in the bleb wall. However, SDOCT had limited clinical utility in that it did not provide useful information about deep features such as flap position, bleb cavity formation or patency of the subflap space and internal ostium.

Original languageEnglish (US)
Pages (from-to)345-351
Number of pages7
JournalClinical and Experimental Ophthalmology
Volume37
Issue number4
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Trabeculectomy
Optical Coherence Tomography
Blister

Keywords

  • Glaucoma
  • Imaging
  • Optical coherence tomography
  • Trabeculectomy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

High-definition imaging of trabeculectomy blebs using spectral domain optical coherence tomography adapted for the anterior segment. / Singh, Mandeep; See, Jovina L S; Aquino, Maria C.; Thean, Lennard S Y; Chew, Paul T K.

In: Clinical and Experimental Ophthalmology, Vol. 37, No. 4, 2009, p. 345-351.

Research output: Contribution to journalArticle

@article{b90013428ab845d0959c3c77902f0fa9,
title = "High-definition imaging of trabeculectomy blebs using spectral domain optical coherence tomography adapted for the anterior segment",
abstract = "Background: The aim of this work was to image trabeculectomy blebs using spectral domain optical coherence tomography (SDOCT). Methods: In this prospective cross-sectional study, patients who had undergone trabeculectomy with at least 3 months of follow up were included. Blebs were imaged using an adapted SDOCT system (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA) and time domain anterior segment optical coherence tomography (ASOCT) (Visante OCT, Carl Zeiss Meditec Inc.). An observer masked to clinical data assessed the utility of SDOCT and ASOCT in visualizing structures in successful and failed blebs. Results: Fifty-one eyes were imaged, of which 43 (84.3{\%}) were successful. SDOCT showed wall thickening (93.0{\%} vs. 67.4{\%}, P = 0.006) and discrete hyporeflective spaces in the wall (88.4{\%} vs. 14.0{\%}, P <0.0001) in a greater proportion of successful blebs than ASOCT. SDOCT showed the bleb cavity (23.3{\%} vs. 48.8{\%}, P = 0.02), scleral flap (34.9{\%} vs. 90.7{\%}, P <0.0001), subflap space (20.9{\%} vs. 72.1{\%}, P <0.0001) and ostium (9.3{\%} vs. 88.4{\%}, P <0.0001) in fewer successful blebs than ASOCT. The internal ostium was not visualized in any failed bleb using SDOCT, whereas ASOCT showed the ostium in 87.5{\%} of failed blebs (P = 0.001). SDOCT showed cystic spaces in the bleb wall in a greater proportion of successful blebs than failed blebs (88.4{\%} vs. 37.5{\%}, P = 0.005). Conclusions: SDOCT imaging was able to show fine superficial features in the bleb wall. However, SDOCT had limited clinical utility in that it did not provide useful information about deep features such as flap position, bleb cavity formation or patency of the subflap space and internal ostium.",
keywords = "Glaucoma, Imaging, Optical coherence tomography, Trabeculectomy",
author = "Mandeep Singh and See, {Jovina L S} and Aquino, {Maria C.} and Thean, {Lennard S Y} and Chew, {Paul T K}",
year = "2009",
doi = "10.1111/j.1442-9071.2009.02066.x",
language = "English (US)",
volume = "37",
pages = "345--351",
journal = "Clinical and Experimental Ophthalmology",
issn = "1442-6404",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - High-definition imaging of trabeculectomy blebs using spectral domain optical coherence tomography adapted for the anterior segment

AU - Singh, Mandeep

AU - See, Jovina L S

AU - Aquino, Maria C.

AU - Thean, Lennard S Y

AU - Chew, Paul T K

PY - 2009

Y1 - 2009

N2 - Background: The aim of this work was to image trabeculectomy blebs using spectral domain optical coherence tomography (SDOCT). Methods: In this prospective cross-sectional study, patients who had undergone trabeculectomy with at least 3 months of follow up were included. Blebs were imaged using an adapted SDOCT system (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA) and time domain anterior segment optical coherence tomography (ASOCT) (Visante OCT, Carl Zeiss Meditec Inc.). An observer masked to clinical data assessed the utility of SDOCT and ASOCT in visualizing structures in successful and failed blebs. Results: Fifty-one eyes were imaged, of which 43 (84.3%) were successful. SDOCT showed wall thickening (93.0% vs. 67.4%, P = 0.006) and discrete hyporeflective spaces in the wall (88.4% vs. 14.0%, P <0.0001) in a greater proportion of successful blebs than ASOCT. SDOCT showed the bleb cavity (23.3% vs. 48.8%, P = 0.02), scleral flap (34.9% vs. 90.7%, P <0.0001), subflap space (20.9% vs. 72.1%, P <0.0001) and ostium (9.3% vs. 88.4%, P <0.0001) in fewer successful blebs than ASOCT. The internal ostium was not visualized in any failed bleb using SDOCT, whereas ASOCT showed the ostium in 87.5% of failed blebs (P = 0.001). SDOCT showed cystic spaces in the bleb wall in a greater proportion of successful blebs than failed blebs (88.4% vs. 37.5%, P = 0.005). Conclusions: SDOCT imaging was able to show fine superficial features in the bleb wall. However, SDOCT had limited clinical utility in that it did not provide useful information about deep features such as flap position, bleb cavity formation or patency of the subflap space and internal ostium.

AB - Background: The aim of this work was to image trabeculectomy blebs using spectral domain optical coherence tomography (SDOCT). Methods: In this prospective cross-sectional study, patients who had undergone trabeculectomy with at least 3 months of follow up were included. Blebs were imaged using an adapted SDOCT system (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA) and time domain anterior segment optical coherence tomography (ASOCT) (Visante OCT, Carl Zeiss Meditec Inc.). An observer masked to clinical data assessed the utility of SDOCT and ASOCT in visualizing structures in successful and failed blebs. Results: Fifty-one eyes were imaged, of which 43 (84.3%) were successful. SDOCT showed wall thickening (93.0% vs. 67.4%, P = 0.006) and discrete hyporeflective spaces in the wall (88.4% vs. 14.0%, P <0.0001) in a greater proportion of successful blebs than ASOCT. SDOCT showed the bleb cavity (23.3% vs. 48.8%, P = 0.02), scleral flap (34.9% vs. 90.7%, P <0.0001), subflap space (20.9% vs. 72.1%, P <0.0001) and ostium (9.3% vs. 88.4%, P <0.0001) in fewer successful blebs than ASOCT. The internal ostium was not visualized in any failed bleb using SDOCT, whereas ASOCT showed the ostium in 87.5% of failed blebs (P = 0.001). SDOCT showed cystic spaces in the bleb wall in a greater proportion of successful blebs than failed blebs (88.4% vs. 37.5%, P = 0.005). Conclusions: SDOCT imaging was able to show fine superficial features in the bleb wall. However, SDOCT had limited clinical utility in that it did not provide useful information about deep features such as flap position, bleb cavity formation or patency of the subflap space and internal ostium.

KW - Glaucoma

KW - Imaging

KW - Optical coherence tomography

KW - Trabeculectomy

UR - http://www.scopus.com/inward/record.url?scp=67651151166&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67651151166&partnerID=8YFLogxK

U2 - 10.1111/j.1442-9071.2009.02066.x

DO - 10.1111/j.1442-9071.2009.02066.x

M3 - Article

VL - 37

SP - 345

EP - 351

JO - Clinical and Experimental Ophthalmology

JF - Clinical and Experimental Ophthalmology

SN - 1442-6404

IS - 4

ER -