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Confocal microscopy helpful in evaluating bleb function, study suggests
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Confocal microscopy can allow glaucoma specialists to examine structures in filtering blebs that are not visible with slit-lamp biomicroscopy, a study shows. Some features identified may also indicate blub function, the study authors said.
Rainer Guthoff, MD, and colleagues at the University Hospital of Würzburg, Germany, used the Rostock Cornea Module of the Heidelberg Retina Tomograph II (Heidelberg Engineering) to distinguish in vivo stromal patterns, cystic spaces and cellular infiltrates in 52 eyes of 48 patients after trabeculectomy. The researchers pair-matched nine early-functioning and 17 late-functioning blebs with malfunctioning blebs to examine the relationship of these features to bleb function.
Patients were examined an average 375 days after trabeculectomy. Using confocal microscopy, the researchers defined four stromal patterns undetectable with slit-lamp biomicroscopy: trabecular, reticular, corrugated and compacted.
Trabecular patterns were seen only in eyes with functioning blebs. Intraepithelial cystic spaces were associated with late-functioning blebs, while stromal cystic spaces were associated with early-functioning blebs, according to the study authors.
Late-functioning blebs had a higher density of intraepithelial and stromal round cells than malfunctioning late blebs.
"The predictive value of these features deserves further clarification in a prospective longitudinal study," the authors said.
The study is published in the December issue of the Journal of Glaucoma.