The Role of Optical Coherence Tomography Angiography in Glaucoma

Glaucoma is the second leading cause of blindness worldwide, affecting eighty million people globally and three million patients in the USA. Primary open-angle glaucoma, the most common type, is a multifactorial progressive optic nerve neurodegenerative disorder that leads to loss of optic nerve head (ONH) tissue, thinning of the retinal nerve fiber layer, and corresponding visual field (VF) defects with or without elevated intraocular pressure (IOP). Risk factors include older age, black or Hispanic race, elevated IOP, thin central corneal thickness, disk hemorrhage, and low ocular perfusion pressure. The two prevalent theories explaining glaucomatous damage are mechanical (elevated IOP) and vascular (compromised optic nerve perfusion). Current diagnostic methods, such as measuring IOP, VF testing, and ONH evaluation, are subjective and often unreliable. Optical coherence tomography angiography (OCTA) is a rapid, non-invasive imaging modality that provides 3-D, volumetric details of both the structure and vascular networks of the retina and optic nerve. Various researchers have shown that OCTA provides an accurate and objective evaluation of the retina and the optic nerve in glaucoma. This chapter describes the role of OCTA in managing patients with glaucoma

Wound Modulations in Glaucoma Surgery: A Systematic Review

Excessive fibrosis and resultant poor control of intraocular pressure (IOP) reduce the efficacy of glaucoma surgeries. Historically, corticosteroids and anti-fibrotic agents, such as mitomycin C (MMC) and 5-fluorouracil (5-FU), have been used to mitigate post-surgical fibrosis, but these have unpredictable outcomes. Therefore, there is a need to develop novel treatments which provide increased effectiveness and specificity. This review aims to provide insight into the pathophysiology behind wound healing in glaucoma surgery, as well as the current and promising future wound healing agents that are less toxic and may provide better IOP control