Ophthalmol Glaucoma
Hamilton Glaucoma Center, Shiley Eye Institute, and Department of Ophthalmology University of California, San Diego, CA, USA.
Published: August 2021
Purpose: To study changes in aqueous humor outflow (AHO) patterns after trabecular micro-bypass (TMB) in glaucoma patients using intraoperative sequential aqueous angiography.
Design: Prospective comparative case series.
Subjects: Fifteen subjects (14 with glaucoma and 1 normal).
Methods: Sequential aqueous angiography (Spectralis HRA+OCT; Heidelberg Engineering) was performed on fourteen glaucoma patients undergoing routine TMB (iStent Inject; Glaukos Corporation) and cataract surgery and one normal patient undergoing cataract surgery alone. Indocyanine green (ICG) aqueous angiography established initial baseline nasal angiographic AHO patterns. Two TMB stents were placed in regions of baseline low or high angiographic AHO in each eye (n = 2 eyes with enough space to place two stents in both low angiographic regions; n = 8 eyes with two stents both placed in high angiographic regions; n = 4 eyes with enough space to place one stent in a low angiographic region and the other stent in a high angiographic region). Subsequent fluorescein aqueous angiography was utilized to query alterations to angiographic AHO patterns.
Main Outcome Measure: Angiographic signal and patterns before and after TMB.
Results: At baseline, all eyes showed segmental angiographic AHO patterns. Focused on the nasal hemisphere of each eye, for each stent TMB in initially low ICG angiographic signal regions showed transient or persistently improved fluorescein angiographic signal (11.2-fold; = 0.014). TMB in initially high ICG signal regions led to faster development of fluorescein angiographic patterns (3.1-fold; = 0.02).
Conclusion: TMB resulted in different patterns of aqueous angiographic AHO improvement whose further understanding may advance basic knowledge of AHO and possibly enhance intraocular pressure reduction after glaucoma surgery in the future.
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http://dx.doi.org/10.1016/j.ogla.2018.11.010 | DOI Listing |
Indian J Ophthalmol
July 2024
Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi, India.
Aqueous humor outflow (AHO) pathways are the main site of resistance causing elevated intraocular pressure in glaucoma, especially primary open-angle glaucoma patients. With the recently introduced technique of aqueous angiography (AA); functional, real time assessment of AHO from proximal (trabecuar meshwork) to distal pathways under physiological conditions has been made possible. AHO pathways are segmental, and AA can identify high-flow region (increased angiographic signals) and low flow region (decreased angiographic signals) in an individual.
View Article and Find Full Text PDFTransl Vis Sci Technol
March 2024
Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, San Diego, CA, USA.
Purpose: To compare aqueous humor outflow (AHO) pathway patterns between eyes of childhood glaucoma patients and non-glaucomatous patients receiving cataract surgery.
Methods: Aqueous angiography was performed in childhood glaucoma eyes (n = 5) receiving glaucoma surgery and in pediatric (n = 1) and healthy adult (n = 5) eyes receiving cataract surgery. Indocyanine green (0.
J Glaucoma
May 2024
Hamilton Glaucoma Center, The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, CA.
Prcis: Trabecular meshwork (TM) pigmentation is not correlated with angiographically determined aqueous humor outflow (AHO) in an ex vivo perfusion model using human eyes.
Purpose: To evaluate whether segmental TM pigmentation is correlated to segmental AHO in human eyes.
Methods: Postmortem human eyes were acquired, and anterior segments were dissected.
Ophthalmol Glaucoma
August 2021
Hamilton Glaucoma Center, Shiley Eye Institute, and Department of Ophthalmology University of California, San Diego, CA, USA.
Purpose: To study changes in aqueous humor outflow (AHO) patterns after trabecular micro-bypass (TMB) in glaucoma patients using intraoperative sequential aqueous angiography.
Design: Prospective comparative case series.
Subjects: Fifteen subjects (14 with glaucoma and 1 normal).
J Glaucoma
November 2018
Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA.
Purpose: To evaluate aqueous humor outflow (AHO) in intact eyes of live human subjects during cataract surgery using fluorescein aqueous angiography.
Methods: Aqueous angiography was performed in 8 live human subjects (56 to 86 y old; 2 men and 6 women). After anesthesia, fluorescein (2%) was introduced into the eye [either alone or after indocyanine green (ICG; 0.
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