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Marek Rekas, Milena Kozera, Monika Danielewska, Katarzyna Lewczuk, Joanna Jablonska, Robert Iskander; Evaluation of conventional aqueous outflow pathway function by fluorophotometry.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2096.
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© ARVO (1962-2015); The Authors (2016-present)
The objective of this study was to evaluate the function of the conventional aqueous drainage path, on an outpatient basis, based on changes of fluorescein concentrations over the course of its elimination from the anterior chamber.
52 persons (average age - 72 years), assigned to 3 groups, took part in the prospective case series study. The first group was made up of 19 cases with diagnosed primary open angle glaucoma, the second group consisted of 22 cases with cataract, and the remaining 21 persons made up control group 3. Fluorophotometric measurements were taken for all patients. The test protocol encompassed administration of a saturating dose of fluorescein into the conjunctival sac, followed by measurements of fluorescein concentrations at four points in time: immediately after administration of fluorescein, 2, 4 and 6 hours after saturation. Changes in the dye's concentration were analyzed in the cornea and anterior chamber at individual points in time. A custom procedure, written in Matlab, was used to automatically estimate the amount of fluorescein in the cornea and anterior chamber (parameters FC and FAC, respectively).
Immediately after administration of fluorescein, the maximum value of the cornea signal FC increased significantly in all groups, and no statistically significant differences between groups were observed at this time. A statistically significant difference was obtained for the FC parameter after 2h and 6h in the glaucoma group compared to the control group and cataract group (respectively, p=0.044 and p=0.041). After 2h and 6h, FC in the glaucoma group decreased from 91 to 64 [ng/mL], in the control group, this parameter was maintained at a level of 46 and 42 [ng/mL]. A statistically significant difference was obtained for the FAC parameter after 4h and 6h in the glaucoma group compared to the control group and cataract group (respectively, p=0.017 and p=0.003). After 4h and 6h, FAC in the glaucoma group was maintained at a level of 42 and 34 [ng/mL], in the cataract group, this parameter decreased from 29 to 22 [ng/mL], and the values for the control group decreased from 20 to 18 [ng/mL].
Obtained results confirm the efficacy of this method in diagnostics of drainage path function. Fluorophotometry may be a tool that makes it possible to detect irregularities in conventional aqueous drainage path function in a safe and non-invasive manner.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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