A pilot study on slit lamp-adapted optical coherence tomography imaging of trabeculectomy filtering blebs

Abstract

Successful filtering blebs show characteristic optical properties on SL-OCT. These phenomena suggest a diffusely enhanced fluid content and the presence of intra-bleb drainage channels in functional filtering blebs.

Early trabeculectomy bleb walls on anterior-segment optical coherence tomography

“…It has been reported that in early blebs, the appearance of subconjunctival microcysts on slit-lamp biomicroscopy and subconjunctival multiple low-reflective layers ("striping") on slit-lamp-adapted OCT (SL-OCT) predicted a good outcome, but the appearance of corkscrew vessels on slit-lamp biomicroscopy predicted a poor outcome. These results support the possibility that features of early developing bleb walls can predict bleb function [19,20].…”

Correlation of Filtration Bleb Morphology With Histology

“…22 More recently, blebs were characterized using ultrasound biomicroscopy [23][24][25] and anterior segment optical coherence tomography. 16,26,27 By measuring elevation, wall thickness and volume of the ''filtration reservoir'' these technologies have demonstrated considerable correlation between clinical success and bleb height/volume and have suggested internal ostium occlusion, tight scleral flap apposition, and subconjunctival fibrosis as the major reasons for failure. 16 …”

Imaging of trabeculectomy blebs with Visante anterior segment optical coherence tomography after digital ocular compression

“…IOP correlated with bleb height, internal cavity height, and extent of the internal cavity. Also, low intrableb reflectivity, episcleral fluid, and microcysts were identified in the images of the mature bleb and shown to be related with bleb function and IOP [16,[18][19][20]. Many reports support the notion that AS-OCT is useful in identifying intrableb morphology, and intrableb morphology was shown to be an important aspect in predicting bleb function [21].…”

“…Such advantages translate into more accurate and reproducible images for direct and objective bleb assessment and measurement. Recent studies reported that the internal bleb morphology can be visualized and analyzed using OCT [14][15][16][17]. IOP correlated with bleb height, internal cavity height, and extent of the internal cavity.…”