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Abstract #99196 Published in IGR 22-4
Anterior Segment Optical Coherence Tomography Angiography Following Trabecular Bypass Minimally Invasive Glaucoma Surgery
Gan J; Gan J; Sng CCA; Ke M; Chieh CS; Tan B; Schmetterer L; Ang MFrontiers in medicine 2022; 9: 830678
OBJECTIVE: To assess anterior segment optical coherence tomography angiography (AS-OCTA) imaging of the episcleral vessels before and after trabecular bypass minimally invasive glaucoma surgery (MIGS). DESIGN: A prospective, clinical, single-centre, single-arm pilot feasibility study conducted at National University Hospital, Singapore. SUBJECTS: Patients with primary glaucomatous optic neuropathy undergoing Hydrus Microstent (Ivantis Inc., Irvine, CA, USA) implantation, who require at least one intra-ocular pressure-lowering medication. One or two eyes per patient may be enrolled. METHODS: We performed AS-OCTA (Nidek RS-3000 Advance 2, Gamagori, Japan) pre- and up to 6 months post-MIGS implantation using a standard protocol in all cornealimbal quadrants, to derive episcleral vessel densities (VD) using a previously described technique. MAIN OUTCOME MEASURES: Episcleral VD pre- and post-surgery, in sectors with and without the implant. RESULTS: We obtained serial AS-OCTA images in 25 eyes undergoing MIGS implantation (23 subjects, mean age 70.3 ± 1.5, 61% female) with mean preoperative intraocular pressure (IOP) of 15.5 mmHg ± 4.0. We observed reductions in postoperative episcleral VD compared to preoperative VD at month 1 (mean difference -3.2, = 0.001), month 3 (mean difference -2.94, = 0.004) and month 6 (mean difference -2.19, = 0.039) in sectors with implants (overall 6 month follow-up, = 0.011). No significant changes were detected in episcleral VD in the sectors without implants ( = 0.910). CONCLUSION: In our pilot study, AS-OCTA was able to detect changes in the episcleral VD following trabecular bypass MIGS, which may be a useful modality to evaluate surgical outcomes if validated in future studies.
Duke-NUS Graduate Medical School, Singapore, Singapore.
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