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Liang Liu, Brock Alonzo, Hana Takusagawa, John C Morrison, Beth Edmunds, Shandiz Tehrani, Yali Jia, David Huang; Optical Coherence Tomography Angiography of Peripapillary Retina Pre- and Post- Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5057.
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To determine if trabeculectomy alters retinal perfusion using projection-resolved optical coherence tomography angiography (PR-OCTA).
This observational longitudinal study enrolled patients with glaucoma who underwent trabeculectomy due to inadequate control of intraocular pressure. One eye of each subject was scanned using the AngioVue 4.5-mm OCTA preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. The capillary density (CD) of 4 OCTA slabs were analyzed: nerve fiber layer plexus (NFLP), superficial vascular complex (SVC), deep vascular complex (DVC), and all plexuses combined.
OCT angiography scans from 15 glaucoma patients were analyzed using PR-OCTA. NFLP CD increased 10.5% at 6 months (p = 0.006) and SVC CD increased 9.1% at 6 months (p = 0.002). DVC CD was similar at 6 months (p = 0.79). All plexus CD increased 4.9% at 6 months (p = 0.013). Intraocular pressure decreased following trabeculectomy at 6 months (p = 0.004).
Capillary density increased more in the nerve fiber layer plexus than the deeper plexus following trabeculectomy. Focal capillary dropout could be visualized in the nerve fiber layer plexus of glaucomatous eyes. Structural and angiographic OCT parameters may be useful in the clinical evaluation of glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1. Focal capillary dropout (arrow) visualized in NFLP, SVC and all-plexus retina angiograms, but not in DVC.
Figure 2. Comparison of mean IOP vs NFLP capillary density following trabeculectomy.
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