Bleb morphology of glaucoma drainage devices on magnetic resonance imaging

Rafael Correia Barão; David Berhanu; Diogo Bernardo Matos; André Diogo Barata; Rita Sousa; Luís Abegão Pinto

doi:10.1111/aos.15668

Bleb morphology of glaucoma drainage devices on magnetic resonance imaging

Rafael Correia Barão^*, David Berhanu, Diogo Bernardo Matos, André Diogo Barata, Rita Sousa, Luís Abegão Pinto

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Purpose: To evaluate bleb morphology features of different glaucoma drainage devices (GDD) using magnetic resonance imaging (MRI). Materials and Methods: Prospective cohort study of GDD and bleb morphology in consecutive glaucoma patients implanted with Ahmed Glaucoma Valve (AGV), Paul Glaucoma Implant (PGI), Baerveldt Glaucoma Implant (BGI) and Ahmed ClearPath (ACP) devices. Thirty-six eyes from 30 consecutive patients underwent standardized GDD implantation followed by MRI at least 1 month after surgery. Main outcomes included bleb volume and endplate position relative to the optic nerve. Secondary outcomes included intraocular pressure (IOP), medication and surgical complications during a 12-month follow-up. Results: Seven eyes were implanted with the AGV (19%), 5 with BGI (14%), 16 with PGI (44%) and 8 with ACP (22%). MRI scans were obtained 85 ± 66 days after surgery. Mean total bleb volume was 563 ± 390 mm³. This bleb volume was inversely correlated with early post-operative IOP (day 7; r_s = −0.3326, p = 0.0475) but positively correlated with IOP at 12 months (r_s = 0.3592, p = 0.0341). No significant difference in total bleb volume was found between GDD types (p = 0.1223). A double-layered bleb was observed in 34 eyes (94%). The inferior bleb volume was significantly larger in PGI devices versus other GDD types (380 ± 205 vs. 193 ± 161 mm³; p = 0.0043). Distance from the endplate to the optic nerve was 9.5 ± 4.0 mm, similar across GDDs (p = 0.2519). Conclusions: Double-layered blebs are a common finding with GDDs. Bleb volume showed different correlations with IOP at distinct timepoints and the PGI device formed larger blebs. A standardized GDD implantation technique ensures a safe distance from the GDD endplate to the optic nerve.

Original language	English
Pages (from-to)	789–796
Number of pages	8
Journal	Acta Ophthalmologica
Volume	101
Issue number	7
DOIs	https://doi.org/10.1111/aos.15668
Publication status	Published - Nov 2023
Externally published	Yes

Keywords

Aqueous shunt
Glaucoma
Glaucoma surgery
Long tube
Magnetic resonance imaging
Orbit

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10.1111/aos.15668Licence: CC BY-NC

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@article{994d6326b52841509d51d505a5acf2d3,

title = "Bleb morphology of glaucoma drainage devices on magnetic resonance imaging",

abstract = "Purpose: To evaluate bleb morphology features of different glaucoma drainage devices (GDD) using magnetic resonance imaging (MRI). Materials and Methods: Prospective cohort study of GDD and bleb morphology in consecutive glaucoma patients implanted with Ahmed Glaucoma Valve (AGV), Paul Glaucoma Implant (PGI), Baerveldt Glaucoma Implant (BGI) and Ahmed ClearPath (ACP) devices. Thirty-six eyes from 30 consecutive patients underwent standardized GDD implantation followed by MRI at least 1 month after surgery. Main outcomes included bleb volume and endplate position relative to the optic nerve. Secondary outcomes included intraocular pressure (IOP), medication and surgical complications during a 12-month follow-up. Results: Seven eyes were implanted with the AGV (19%), 5 with BGI (14%), 16 with PGI (44%) and 8 with ACP (22%). MRI scans were obtained 85 ± 66 days after surgery. Mean total bleb volume was 563 ± 390 mm3. This bleb volume was inversely correlated with early post-operative IOP (day 7; rs = −0.3326, p = 0.0475) but positively correlated with IOP at 12 months (rs = 0.3592, p = 0.0341). No significant difference in total bleb volume was found between GDD types (p = 0.1223). A double-layered bleb was observed in 34 eyes (94%). The inferior bleb volume was significantly larger in PGI devices versus other GDD types (380 ± 205 vs. 193 ± 161 mm3; p = 0.0043). Distance from the endplate to the optic nerve was 9.5 ± 4.0 mm, similar across GDDs (p = 0.2519). Conclusions: Double-layered blebs are a common finding with GDDs. Bleb volume showed different correlations with IOP at distinct timepoints and the PGI device formed larger blebs. A standardized GDD implantation technique ensures a safe distance from the GDD endplate to the optic nerve.",

keywords = "Aqueous shunt, Glaucoma, Glaucoma surgery, Long tube, Magnetic resonance imaging, Orbit",

author = "Bar{\~a}o, {Rafael Correia} and David Berhanu and Diogo Bernardo Matos and Barata, {Andr{\'e} Diogo} and Rita Sousa and Lu{\'i}s Abeg{\~a}o Pinto",

note = "Funding Information: Interim results of this project were presented at the 2022 ARVO meeting (May 1–52 022, Denver, Colorado, USA). Consequently the abstract for this presentation was published: Rafael Correia Bar{\~a}o et al.; Magnetic Resonance Imaging of Glaucoma Drainage Devices. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3710 – A0395. Publisher Copyright: {\textcopyright} 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.",

year = "2023",

month = nov,

doi = "10.1111/aos.15668",

language = "English",

volume = "101",

pages = "789–796",

journal = "Acta Ophthalmologica",

issn = "1755-375X",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "7",

}

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T1 - Bleb morphology of glaucoma drainage devices on magnetic resonance imaging

AU - Barão, Rafael Correia

AU - Berhanu, David

AU - Bernardo Matos, Diogo

AU - Barata, André Diogo

AU - Sousa, Rita

AU - Abegão Pinto, Luís

N1 - Funding Information: Interim results of this project were presented at the 2022 ARVO meeting (May 1–52 022, Denver, Colorado, USA). Consequently the abstract for this presentation was published: Rafael Correia Barão et al.; Magnetic Resonance Imaging of Glaucoma Drainage Devices. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3710 – A0395. Publisher Copyright: © 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

PY - 2023/11

Y1 - 2023/11

N2 - Purpose: To evaluate bleb morphology features of different glaucoma drainage devices (GDD) using magnetic resonance imaging (MRI). Materials and Methods: Prospective cohort study of GDD and bleb morphology in consecutive glaucoma patients implanted with Ahmed Glaucoma Valve (AGV), Paul Glaucoma Implant (PGI), Baerveldt Glaucoma Implant (BGI) and Ahmed ClearPath (ACP) devices. Thirty-six eyes from 30 consecutive patients underwent standardized GDD implantation followed by MRI at least 1 month after surgery. Main outcomes included bleb volume and endplate position relative to the optic nerve. Secondary outcomes included intraocular pressure (IOP), medication and surgical complications during a 12-month follow-up. Results: Seven eyes were implanted with the AGV (19%), 5 with BGI (14%), 16 with PGI (44%) and 8 with ACP (22%). MRI scans were obtained 85 ± 66 days after surgery. Mean total bleb volume was 563 ± 390 mm3. This bleb volume was inversely correlated with early post-operative IOP (day 7; rs = −0.3326, p = 0.0475) but positively correlated with IOP at 12 months (rs = 0.3592, p = 0.0341). No significant difference in total bleb volume was found between GDD types (p = 0.1223). A double-layered bleb was observed in 34 eyes (94%). The inferior bleb volume was significantly larger in PGI devices versus other GDD types (380 ± 205 vs. 193 ± 161 mm3; p = 0.0043). Distance from the endplate to the optic nerve was 9.5 ± 4.0 mm, similar across GDDs (p = 0.2519). Conclusions: Double-layered blebs are a common finding with GDDs. Bleb volume showed different correlations with IOP at distinct timepoints and the PGI device formed larger blebs. A standardized GDD implantation technique ensures a safe distance from the GDD endplate to the optic nerve.

AB - Purpose: To evaluate bleb morphology features of different glaucoma drainage devices (GDD) using magnetic resonance imaging (MRI). Materials and Methods: Prospective cohort study of GDD and bleb morphology in consecutive glaucoma patients implanted with Ahmed Glaucoma Valve (AGV), Paul Glaucoma Implant (PGI), Baerveldt Glaucoma Implant (BGI) and Ahmed ClearPath (ACP) devices. Thirty-six eyes from 30 consecutive patients underwent standardized GDD implantation followed by MRI at least 1 month after surgery. Main outcomes included bleb volume and endplate position relative to the optic nerve. Secondary outcomes included intraocular pressure (IOP), medication and surgical complications during a 12-month follow-up. Results: Seven eyes were implanted with the AGV (19%), 5 with BGI (14%), 16 with PGI (44%) and 8 with ACP (22%). MRI scans were obtained 85 ± 66 days after surgery. Mean total bleb volume was 563 ± 390 mm3. This bleb volume was inversely correlated with early post-operative IOP (day 7; rs = −0.3326, p = 0.0475) but positively correlated with IOP at 12 months (rs = 0.3592, p = 0.0341). No significant difference in total bleb volume was found between GDD types (p = 0.1223). A double-layered bleb was observed in 34 eyes (94%). The inferior bleb volume was significantly larger in PGI devices versus other GDD types (380 ± 205 vs. 193 ± 161 mm3; p = 0.0043). Distance from the endplate to the optic nerve was 9.5 ± 4.0 mm, similar across GDDs (p = 0.2519). Conclusions: Double-layered blebs are a common finding with GDDs. Bleb volume showed different correlations with IOP at distinct timepoints and the PGI device formed larger blebs. A standardized GDD implantation technique ensures a safe distance from the GDD endplate to the optic nerve.

KW - Aqueous shunt

KW - Glaucoma

KW - Glaucoma surgery

KW - Long tube

KW - Magnetic resonance imaging

KW - Orbit

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U2 - 10.1111/aos.15668

DO - 10.1111/aos.15668

M3 - Article

C2 - 37066864

AN - SCOPUS:85153324111

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EP - 796

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

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ER -

Bleb morphology of glaucoma drainage devices on magnetic resonance imaging

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