June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Functional Predictive Value of a Novel Classification System by Anterior Segment OCT in Assessing Filtering Blebs
Author Affiliations & Notes
  • Ana María Ponce Horta
    INSTITUTO DE OFTALMOLOGIA Y CIENCIAS VISUALES, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
    Asistencia e Investigación en Glaucoma, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
  • Jose A Paczka
    INSTITUTO DE OFTALMOLOGIA Y CIENCIAS VISUALES, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
    Asistencia e Investigación en Glaucoma, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
  • Daniel Valencia Paredes
    RESEARCH DEPARMENT, Unidad de Diagnóstico Temprano del Glaucoma, MEXICO (MEX), Jalisco, Mexico
  • Andrea Tornero-Jimenez
    INSTITUTO DE OFTALMOLOGIA Y CIENCIAS VISUALES, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
    Asistencia e Investigación en Glaucoma, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
  • Footnotes
    Commercial Relationships   Ana Ponce Horta None; Jose Paczka None; Daniel Valencia Paredes None; Andrea Tornero-Jimenez None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3702 – A0387. doi:
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      Ana María Ponce Horta, Jose A Paczka, Daniel Valencia Paredes, Andrea Tornero-Jimenez; Functional Predictive Value of a Novel Classification System by Anterior Segment OCT in Assessing Filtering Blebs. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3702 – A0387.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Trabeculectomy is the most practiced surgery in glaucoma, and filtering blebs are usually studied with multiple classifications. The weak correlation of an anterior segment OCT (AS-OCT) classification with IOP in a preliminary cross-sectional study (ARVO 2021) suggested that the classification could have some predictive value. The objective of this study is to analyze the correlation between the Novel Classification System by AS-OCT (NOCTS) and the combination of NOCTS and the Würzburg classification (NOCTS+WC) with the filtering bleb functionality in a longitudinal study.

Methods : Longitudinal study of non-consecutive cases of patients with trabeculectomy. Fifty eyes of thirty-three patients were included. Filtering blebs were examined using the WC (score range, 0-12). A series of AS-OCT images were also evaluated using NOCTS (score range, 0-6) to evaluate 3 tomographic traits of the filtering bleb (wall thickness, cystic spaces and wall inner reflectivity). A weighted score was assigned to each item for every examined case. The blebs were subclassified into 4 types according to their outcome (complete success, qualified success with compression, qualified success with hypotensive drugs, and failure). The correlation between NOCTS, WC and NOCTS+WC with the baseline outcome and after one year of follow-up were analyzed, considering a p-value of ≤ 0.05 as statistically significant.

Results : Patients had a mean age of 60.1±17.7, predominantly female (72.7%), with POAG (51.5%), and pseudophakic (62%). The mean time after trabeculectomy was 49.5±64.1 months. The correlation of NOCTS with the baseline outcome was weak to moderate (r=0.372, p=0.008), and moderate at one year of follow-up (r=0.477 p=0.0001). The correlation of WC with the baseline outcome (r=0.623, p=0.0001) and at one year of follow-up were moderate to strong (r=0.689, p=0.0001). NOCTS+WC score had a strong correlation with the baseline outcome (r=0.788, p=0.0001), as well as at one year of follow-up (r=0.756, p=0.0001).

Conclusions : The combination of clinical and tomographic systems outperformed isolated evaluation with each of these systems, both at baseline, as well as at the one-year post-trabeculectomy outcome. Prospective studies with longer follow-up and larger samples are required to determine this new approach to classify filtering blebs.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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