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Updated: Jan 24, 2026

Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
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Evaluation of Functional Filtering Bleb Using Optical Coherence Tomography Angiography.

Je Hyun Seo1,2, Ye An Kim1,3, Keun Heung Park4

  • 1Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea.

Translational Vision Science & Technology
|May 22, 2019
PubMed
Summary

Optical coherence tomography angiography (OCT-A) effectively evaluates filtering bleb vascularity after trabeculectomy. OCT-A parameters correlate with traditional grading systems, offering objective bleb assessment.

Keywords:
Moorfields Bleb Grading Systembleboptical coherence tomography angiographytrabeculectomy

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Medical Imaging

Background:

  • Filtering blebs are crucial for glaucoma surgery success.
  • Assessing bleb vascularity traditionally relies on subjective grading scales.
  • Objective methods for bleb evaluation are needed.

Purpose of the Study:

  • To investigate the utility of optical coherence tomography angiography (OCT-A) for evaluating filtering blebs.
  • To compare OCT-A-derived vascularity parameters with conventional bleb grading systems (IBAGS and MBGS).

Main Methods:

  • 92 patients undergoing mitomycin C-augmented trabeculectomy were assessed using OCT-A and anterior segment photography.
  • OCT-A images were analyzed for color and brightness densities within the bleb area.
  • Bleb vascularity was graded using the Indiana Bleb Appearance Grading Scale (IBAGS) and Moorfields Bleb Grading System (MBGS).

Main Results:

  • OCT-A demonstrated excellent inter- and intraobserver reproducibility for vessel density measurements.
  • OCT-A color and brightness densities positively correlated with IBAGS and MBGS vascularity scores.
  • Predictive accuracy for intraocular pressure (IOP) risk was similar between OCT-A parameters and traditional grading systems.

Conclusions:

  • OCT-A is a viable tool for evaluating filtering bleb vascularity.
  • OCT-A provides objective and quantitative vascularity parameters for bleb assessment post-trabeculectomy.
  • OCT-A findings correlate with established bleb grading scales.