Outflow facility and extent of angle closure in a porcine model

Hong, Ying; Wang, Chao; Loewen, Ralitsa T.; Waxman, Susannah; Shah, Priyal; Chen, Si; Esfandiari, Hamed; Loewen, Nils A.

doi:10.1007/s00417-019-04279-1

Cited by 9 publications

(14 citation statements)

References 67 publications

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“…Recent OCTA studies have demonstrated VD dropout in glaucomatous eyes, such as POAG, NTG and PACG 4 , 10 , 25 , 26 . For PACG eyes, the pathogenesis is different from other types of glaucoma 27 , 28 ; thus, circulation alterations may be different in the development of this disease 3 , 11 . But few studies have revealed vasculature loss in PACG.…”

Section: Discussionmentioning

confidence: 96%

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Liu

Jiang

et al. 2020

Sci Rep

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This study analyzed the optical coherence tomography angiography (OCTA) macular parameters in primary angle-closure glaucoma (PACG) patients after acute primary angle closure (APAC) episodes. Thirty-three patients with 33 APAC eyes and 33 primary angle closure suspect (PACS) eyes and 33 age-matched normal subjects (controls) were enrolled. Macular vessel density (VD) in central, inner, outer and full regions and foveal avascular zone (FAZ) parameters (area, perimeter and circularity index) were compared between APAC, PACS, and control eyes. For resolved APAC eyes, the VD in each macular region was significantly lower than that in control eyes, with less central and inner macular VD than PACS eyes. The central macular VD was significantly lower in PACS eyes than in controls. There was no difference in FAZ area and perimeter between APAC, PACS, and control eyes. FAZ circularity was highest in control eyes, followed by PACS eyes, and lowest in APAC eyes. The AUC, sensitivity and specificity of FAZ circularity were 0.944, 93.9% and 84.8%, respectively, in APAC eyes and 0.881, 84.8% and 81.8%, respectively, in PACS eyes. Therefore, FAZ circularity had the best discrimination capability for detecting both APAC and PACS eyes. Macular assessment with OCTA could provide an accurate early-stage diagnostic tool for PACG.

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Section: Discussionmentioning

confidence: 96%

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Liu

Jiang

et al. 2020

Sci Rep

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“…We suspect that inadvertent compression of key elements of the distal outflow tract in the nasal quadrants by the compression ring of the perfusion mount is responsible for this. This would not necessarily lead to an increased IOP because at least 3/4th of the outflow tract has to be compromised 37 , but it can explain the failure to respond to TP and AIT. However, one has to be careful interpreting the results of this subanalysis, as there were only six AIT non-responders in our study with a significantly lower baseline IOP than AIT responders.…”

Section: Discussionmentioning

confidence: 99%

Trabeculopuncture as a predictive test of distal outflow resistance in canal-based surgery

Verma-Fuehring

Dakroub

Han

et al. 2022

Sci Rep

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We investigated whether trabeculopuncture (TP) could detect distal outflow resistance to predict the outcome of canal-based glaucoma surgery such as ab interno trabeculectomy (AIT). These procedures have a high utilization in open angle glaucoma, but fail in eyes with an unidentified distal outflow resistance. We assigned 81 porcine eyes to two groups: trial (n = 42) and control (n = 39). At 24 h, four YAG-laser trabeculopunctures were placed nasally, followed by a 180° AIT at the same site at 48 h. The proportion of TP responders between both AIT groups was compared. Histology and outflow canalograms were determined. Both post-TP and post-AIT IOPs were lower than baseline IOP (p = 0.015 and p < 0.01, respectively). The success rates of TP and AIT were 69% and 85.7%, respectively. Sensitivity and specificity values of TP as predictive test for AIT success were 77.7% and 83.3%, respectively. The positive and negative predictive values were 96.6% and 38.5%, respectively. We conclude that a 10% reduction in IOP after TP can be used as a predictor for the success (> 20% IOP decrease) of 180° AIT in porcine eyes.

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“…We suspect that inadvertent compression of key elements of the distal outflow tract in the nasal quadrants by the compression ring of the perfusion mount is responsible for this. This would not necessarily lead to an increased IOP because at least 3/4th of the outflow tract has to be compromised 37 , but it can explain the failure to respond to TP and AIT. One has to be careful interpreting the results of this subanalysis, however, as there were only six AIT non-responders in our study.…”

Section: Discussionmentioning

confidence: 99%

A Predictive Test of Outflow Enhancement by Ab Interno Trabeculectomy

Verma-Fuehring¹,

Dakroub²,

Han³

et al. 2021

Preprint

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Purpose: To investigate trabeculopuncture (TP) for predicting the outcome of ab interno trabeculectomy (AIT). AIT is an effective, low-risk procedure for open angle glaucoma. Despite widespread utilization, it fails in patients with an unidentified distal outflow resistance. Methods: We bisected 81 enucleated porcine eyes and perfused them for 72 hours. They were assigned to two groups: trial (n=42) and control (n=39). Intraocular pressure (IOP) was measured continuously. At 24 hours, four YAG-laser trabeculopunctures on the nasal trabecular meshwork were performed, followed by a 180° AIT at the same site at 48 hours. Eyes were divided into TP and AIT responders and non-responders; the proportion of TP responders between both AIT groups was compared. Results: Both post-TP and post-AIT IOPs were lower than baseline IOP (p=0.015 and p<0.01, respectively). The success rates of TP and AIT were 69% and 85.7%, respectively. The proportion of TP responders among AIT responders was greater than that of AIT non-responders (p<0.01). Sensitivity and specificity values of TP as predictive test for AIT success were 77.7% and 83.3%, respectively. The positive and negative predictive values were 96.6% and 38.5%, respectively. Conclusion: A 10% reduction in IOP after TP can be used as predictor for the success (>20% IOP decrease) of 180° AIT in porcine eyes.

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Outflow facility and extent of angle closure in a porcine model

Cited by 9 publications

References 67 publications

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Trabeculopuncture as a predictive test of distal outflow resistance in canal-based surgery

A Predictive Test of Outflow Enhancement by Ab Interno Trabeculectomy

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