Hayek Stéphanie, Labbé Antoine, Brasnu Emmanuelle, Hamard Pascale, Baudouin Christophe
Department of Ophthalmology III, Quinze-Vingts Hospital, Paris, France.
Quinze-Vingts Hospital, DHU Sight Restore, INSERM-DHOS CIC, Paris, France.
Transl Vis Sci Technol. 2019 Jul 3;8(4):4. doi: 10.1167/tvst.8.4.4. eCollection 2019.
To evaluate the changes in conjunctival vascularization with optical coherence tomography angiography (OCT-A) before and after filtering surgery and to correlate these results with filtering surgery success.
We evaluated 20 blebs of 20 patients after a first-time trabeculectomy. Conjunctival vascularization was quantified using ImageJ software. Eyes were classified into two groups according to the preoperative conjunctival vessel density: hypovascularized conjunctiva (HypoV; 10 eyes) and hypervascularized conjunctiva (HyperV; 10 eyes). The density of intraepithelial microcysts (0 to 3) was also analyzed.
There were significantly more needling procedures in the HyperV group, with 70% of the eyes undergoing needling during follow-up compared to 20% in the HypoV group ( = 0.012). In the HyperV group, 50% of the eyes required IOP-lowering eyedrops after surgery, compared to 10% in the HypoV group ( = 0.029). HypoV showed significantly more intraepithelial microcysts than did HyperV at 1 week (1.1 vs. 0.4, = 0.0215), 1 month (2.2 vs. 0.4, = 0.0003), and 6 months postoperatively (2.0 vs. 0.7, = 0.0068). A statistically significant correlation was found between preoperative conjunctival vascular density and mean IOP at 1 week ( = 0.483, = 0.038), 1 month ( = 0.714, = 0.001), and 6 months postoperatively ( = 0.471, = 0.043). There was no statistically significant correlation between the preoperative conjunctival vascularization density and the eyedrop-year rate ( = 0.036, = 0.8704) or the preservative-year rate ( = 0.1444, = 0.5107).
Poor conjunctival vascularization was associated with lower IOP and a higher number of intraepithelial microcysts evaluated with OCT-A. OCT-A provides a simple, noninvasive, and reproducible method to analyze and quantify bleb vessels before and after filtering surgery.
Several studies have demonstrated that highly vascularized blebs might be associated with a higher risk of failure. OCT-A may provide a dye-free, noncontact method for monitoring conjunctival vascularization after filtering surgery.
通过光学相干断层扫描血管造影（OCT - A）评估滤过性手术前后结膜血管化的变化，并将这些结果与滤过性手术的成功率相关联。
我们评估了20例首次小梁切除术后患者的20个滤过泡。使用ImageJ软件对结膜血管化进行定量。根据术前结膜血管密度将眼睛分为两组：血管化不足的结膜（HypoV；10只眼）和血管化过度的结膜（HyperV；10只眼）。还分析了上皮内微囊肿的密度（0至3）。
HyperV组的针刺操作明显更多，随访期间70%的眼睛接受了针刺，而HypoV组为20%（P = 0.012）。在HyperV组中，50%的眼睛术后需要使用降低眼压的眼药水，而HypoV组为10%（P = 0.029）。在术后1周（1.1对0.4，P = 0.0215）、1个月（2.2对0.4，P = 0.0003）和6个月（2.0对0.7，P = 0.0068）时，HypoV组的上皮内微囊肿明显多于HyperV组。术前结膜血管密度与术后1周（r = 0.483，P = 0.038）、1个月（r = 0.714，P = 0.001）和6个月（r = 0.471，P = 0.043）时的平均眼压之间存在统计学显著相关性。术前结膜血管化密度与眼药水使用年率（r = 0.036，P = 0.8704）或防腐剂使用年率（r = 0.1444，P = 0.5107）之间无统计学显著相关性。
结膜血管化不良与较低的眼压以及用OCT - A评估的较多上皮内微囊肿相关。OCT - A提供了一种简单、无创且可重复的方法来分析和量化滤过性手术前后的滤过泡血管。
多项研究表明，血管化程度高的滤过泡可能与更高的失败风险相关。OCT - A可能为监测滤过性手术后的结膜血管化提供一种无染料、非接触的方法。
