Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery.

Abstract

PURPOSE:

To describe the use of optical coherence tomography angiography (OCTA) to quantitatively monitor the conjunctival graft revascularization after pterygium excision and conjunctival autograft (CAG) transplantation.

DESIGN:

Prospective, interventional case series.

METHODS:

Ten patients undergoing pterygium excision and femtosecond laser-assisted CAG transplantation were included. OCTA was performed at 1 week, 1 and 3 months postoperatively at the CAG transplantation site and harvested area. The vessel density at three different depths: conjunctival epithelium or CAG epithelium, conjunctival stroma or CAG stroma, and episclera, was evaluated and quantified. The revascularization rate was assessed and correlated with the postoperative CAG thickness.

RESULTS:

No intraoperative and postoperative complications occurred. Reperfusion of the CAGs was observed at 1 week, and early reperfusion within the first month accounted for more than half of graft revascularization. The vessel regrowth density was 9.6±2.6 % and 11.1±2.8 % between 1 week and 1 month, and was 9.8±1.8 % and 11.9±1.9 % between 1 and 3 months, at the CAG and underlying episcleral levels, respectively. All the CAGs were well-perfused at 3 months. The vessel regrowth density was significantly and strongly correlated with the changes of CAG thickness in a negative relationship (γ = -0.94, P = 0.019). At the harvested site, the vascular network of episclera was not affected, and the conjunctival vascularization was restored at 1 month.

CONCLUSIONS:

OCTA is a promising tool to evaluate the vascularization or revascularization of conjunctiva, conjunctival graft and episclera, in a quantitative and serial manner, helping in diseases diagnosis and treatment monitoring. The graft revascularization rate was predictive of postoperative graft deswelling.

• Authors: Yu-Chi Liu, Kavya Devarajan, Tien-En Tan, Marcus Ang, Jodhbir S Mehta
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 207 Pg. 151-158 (11 2019) ISSN: 1879-1891 [Electronic] United States
• PMID: 30959005 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Conjunctiva (blood supply, diagnostic imaging, transplantation)
• Female
• Fluorescein Angiography (methods)
• Follow-Up Studies
• Fundus Oculi
• Humans
• Laser Therapy (methods)
• Male
• Middle Aged
• Neovascularization, Physiologic (physiology)
• Ophthalmologic Surgical Procedures
• Postoperative Period
• Prospective Studies
• Pterygium (diagnosis, physiopathology, surgery)
• Tomography, Optical Coherence (methods)
• Transplantation, Autologous