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Editors Selection IGR 12-2

Clinical Examination Methods: Trabecular OCT

Comment by Tin Aung & Sameer Trikha on:

60496 Morphometry of the trabecular meshwork in vivo in a healthy population using fourier-domain optical coherence tomography, Fernández-Vigo JI; García-Feijóo J; Martínez-de-la-Casa JM et al., Investigative Ophthalmology and Visual Science, 2015; 56: 1782-1788

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Glaucoma is associated with a reduction in aqueous humor outflow through the trabecular meshwork (TM) causing a rise in intraocular pressure. Whilst a number of mechanisms have been postulated to account for a reduction in functionality of the TM, physiological and anatomical studies of TM in vivo, and across different populations, are lacking. Fernandez-Vigo and colleagues describe a large cross-sectional study identifying the morphology of the TM in vivo, using the Fourier Domain RTVue. Interestingly, they found that the length of TM varied largely (range 275-800 microns) with less range for TM area and volume across subjects. The TM was found to be marginally thicker in men than in women (p = 0.046), but no differences were found in TM length or area. Furthermore, no correlations were identified between the TM parameters and axial length, age, sex, IOP or spherical refractive error. The study is particularly interesting as it is one of the first to be conducted in Caucasians. Fourier domain OCT, conducted in vivo, potentially heralds a new era in anterior chamber angle imaging. These devices offer high resolution and speed of image processing. Knowledge of TM morphology may be of relevance in the context of aiding surgical procedures such as angle surgery for glaucoma. TM analysis using OCT devices also opens up the possibility of 'dynamic' assessment of the TM after minimally invasive glaucoma surgery (MIGS), or following the use of medications such as prostaglandin analogues.

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