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Clin Exp OphthalmolSeptember 20251 citations

Anterior Segment Optical Coherence Tomography and Anterior Segment Optical Coherence Tomography Angiography After Bleb Forming Glaucoma Surgeries: A Systematic Review.

Kallab Martin, Huang Alex S, Bolz Matthias, Strohmaier Clemens A


AI Summary

This review found AS-OCT/AS-OCTA shows promise for assessing glaucoma bleb function after surgery, but inconsistent study methods currently limit its routine clinical application.

Abstract

Background

The bleb-forming surgical spectrum in open-angle glaucoma has recently been expanded by novel surgical approaches. Through a medical device implantation (Xen Gel Stent (XGI) or Preserflo Microshunt (PMI)), these procedures aim at more standardised aqueous humour shunting and an intra- and postoperative risk reduction. Postoperatively, however, XEN, PMI and trabeculectomy share their dependence on the proper function of the filtration bleb. This review summarises available literature on anterior segment optical coherence tomography (AS-OCT)- and AS-OCT angiography (AS-OCTA)-based bleb parameters with an emphasis on their association with bleb function.

Methods

A systematic PubMed search was performed to identify the available evidence.

Results

A total of 52 suitable reports were identified and are presented in a structured manner.

Conclusion

The retrieved literature demonstrates that there exists a broad body of evidence for the use of AS-OCT and AS-OCTA after TE, XGI and PMI with the potential for AS-OCT and AS-OCTA enhanced follow-up plans. Their implementation in clinical routine is, however, currently impaired by highly variable and impractical study endpoints, lacking transferability of available evidence between different surgical procedures and missing evidence from prospective interventional trials.


MeSH Terms

HumansTomography, Optical CoherenceAnterior Eye SegmentGlaucoma, Open-AngleTrabeculectomyGlaucoma Drainage ImplantsFluorescein AngiographyIntraocular Pressure

Key Concepts5

There is a broad body of evidence for the use of anterior segment optical coherence tomography (AS-OCT) and AS-OCT angiography (AS-OCTA) after trabeculectomy (TE), Xen Gel Stent (XGI), and Preserflo Microshunt (PMI), with potential for AS-OCT and AS-OCTA enhanced follow-up plans.

DiagnosisReviewSystematic Reviewn=52 suitable reportsCh4Ch28Ch40Ch45

The implementation of anterior segment optical coherence tomography (AS-OCT) and AS-OCT angiography (AS-OCTA) in clinical routine is impaired by highly variable and impractical study endpoints, lacking transferability of available evidence between different surgical procedures, and missing evidence from prospective interventional trials.

MethodologyReviewSystematic Reviewn=52 suitable reportsCh4

The bleb-forming surgical spectrum for open-angle glaucoma has been expanded by novel surgical approaches, including medical device implantation with Xen Gel Stent (XGI) or Preserflo Microshunt (PMI), aiming for more standardized aqueous humour shunting and reduced intra- and postoperative risk.

TreatmentReviewSystematic Reviewn=52 suitable reportsCh40Ch45

Postoperatively, Xen Gel Stent (XEN), Preserflo Microshunt (PMI), and trabeculectomy all depend on the proper function of the filtration bleb.

PrognosisReviewSystematic Reviewn=52 suitable reportsCh40Ch41

A systematic PubMed search identified 52 suitable reports on anterior segment optical coherence tomography (AS-OCT) and AS-OCT angiography (AS-OCTA)-based bleb parameters after bleb-forming glaucoma surgeries.

MethodologyReviewSystematic Reviewn=52 suitable reportsCh4

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