BACKGROUND AND OBJECTIVE
The miniaturization of confocal imaging technology has resulted in the development of a handheld confocal microscope probe capable of fluorescence mode imaging. Findings in the subepithelial tissues of glaucoma filtering blebs using this novel approach for proof of concept are described.
PATIENTS AND METHODS
A fiberoptic confocal imaging probe using an illumination wavelength of 488 nm was applied to the bleb surface of 11 eyes after topical or subconjunctival administration of sodium fluorescein. The imaging plane was moved to the subepithelial region and multiple images from multiple bleb regions were captured at a resolution of 1,024 × 1,024 pixels per square inch.
RESULTS
High-quality images of the bleb wall structure, vasculature, and superficial sclera were obtained and demonstrated subcellular detail. Lateral resolution was between 1 and 1.5 µm and axial resolution was approximately 30 µm. Identifiable structures in the failing blebs included vasculature (including individual erythrocytes, pericytes, and vascular endothelium); microcystic structures; and cells within the Tenon's tissue, some of which resembled fibroblasts.
CONCLUSION
Fluorescence mode imaging of ocular subsurface detail is a viable and promising tool for assessment of wound healing and other processes in trabeculectomy blebs. The ability to image fluorophores creates the possibility of functional imaging.
[Ophthalmic Surg Lasers Imaging 2010;41:78-82.]
AUTHORS
From the Eye Department (AW, LW, WB), Wellington Hospital; and the Capital Vision Research Trust (AW), Wellington, New Zealand.
Accepted for publication February 17, 2009.
Supported by a grant from the Capital Vision Research Trust.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Anthony P. Wells, FRANZCO, Ophthalmology Unit, Department of Surgery, Wellington School of Medicine, Mein Street, Wellington 6008, New Zealand.
doi: 10.3928/15428877-20091230-14
