Abstract

Volume.121 Number.11

Investigation of Filtering Blebs Using Three-dimensional Anterior Segment Optical Coherence Tomography
Sachi Kojima
Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University

Trabeculectomy is a common filtration surgery for glaucoma. Because postoperative morphological changes in filtering blebs caused by wound-healing process affect its function, the understanding of the bleb formation is very important for postoperative management. The recently developed anterior segment optical coherence tomography (AS-OCT) has enabled us to obtain much information about bleb morphology. In particular, using three-dimensional (3D) AS-OCT, we can elucidate the bleb formation continuously. First, we confirmed that 3D AS-OCT bleb images were corresponding with the real morphology in case reports. We then performed a prospective study to evaluate the time-dependent change in six bleb parameters posttrabeculectomy and analyzed the correlations of the parameters with postoperative intraocular pressure (IOP) and the levels of the cytokines in the aqueous humor. The results showed that the width of the filtration openings at 2 weeks posttrabeculectomy was significantly correlated with IOP at 12 months. Moreover, the aqueous humor level of monocyte chemoattractant protein-1 was significantly correlated with the width of the filtration openings. These findings suggested that 3D AS-OCT is a useful tool for the evaluation of internal bleb morphology and that the structural change of filtration openings, which is influenced by the level of aqueous humor cytokine, may be involved in the posttrabeculectomy prognosis.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121:829-836, 2017.

Key words
Three-dimensional anterior segment optical coherence tomography, Trabeculectomy, Filtering blebs, Filtration opening, Aqueous humor
Reprint requests to
Sachi Kojima, M.D., Ph.D. Department of Ophthalmology, Kumamoto University Hospital. 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan