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Zhanlin Zhao, Yu YUE, Chunyi Shao, Yao Fu, Xianqun Fan; Optical coherence tomography angiography for vascular remodeling after pterygium surgery with limbal-conjunctival autograft. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3075.
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© ARVO (1962-2015); The Authors (2016-present)
To perform a perspective observational clinical study using optical coherence tomography angiography(OCTA) in pterygium patients and to demonstrate the vascular remodeling after pterygium surgery with limbal-conjunctival autograft in 3-month follow up.
21 eyes from 19 patients(M:F=7:12; 55.7±18.4y) with primary nasal pterygium were enrolled. The excision of pterygium was followed by a limbal-conjunctival autograft. OCTA(Topcon, Tokyo, Japan) was performed before and 10 days(10d), 1 month(1m) and 3 months(3m) after surgery in nasal quadrant. The total layer of OCT scans was delineated into conjunctival and episcleral layers using IMAGEnet6(Topcon, Tokyo, Japan). The scans were analyzed morphologically in terms of postoperative vascular remodeling of autograft and marginal corneal vascular arcades(MCA). The vessel density of autograft and MCA was quantified using ImageJ software. One-way repeated measures ANOWA test was used for statistical analysis. Data are presented as mean±SEM.
Pterygium presented as abnormal centripetal vascular growth in OCTA scans. The postoperative vessel remodeling was observed to begin in the borders of autograft with tortuous conjunctival capillaries and engorged episcleral vessels at 10d. MCA became increasingly obvious at 1m and 3m(Fig.1). The conjunctival vessel density in nasal quadrant was respectively 45.6±1.4%, 25.6±2.8%, 31.4±1.6% and 36.0±2.1% before and at 10d, 1m and 3m after surgery(F=2.2, P<0.01). The episcleral vessel density was respectively 52.4±1.7%, 29.0±2.2%, 33.8±1.5% and 38.0±1.9% before and at 10d, 1m and 3m after surgery(F=37.4, P<0.01). The vessel density of MCA was respectively 16.6±3.9%，36.2±1.9%，38.5±1.8% at 10d, 1m and 3m after surgery(F=18.5, P<0.01; Fig.2).
We described a new application of OCTA for noninvasive conjunctive and MCA vasculature imaging. Pterygium excision removed the abnormal fibrovascular growth of conjunctive. The vascular remodeling of graft and MCA appeared at 1 month and continued for 3 months after surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Demonstration of OCTA scans of pterygium and episcleral layer of autograft from the same patient. Note tortuous capillaries(red arrows) at 10d and reconstruction of MCA(yellow arrows) after surgery.
Demonstration of conjunctival(A), episcleral(B) and MCA(C) vessel density.*Compared with pre-surgery, P<0.01; #compared with 10d post-op, P<0.05.
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