Eye Pressure Lowering Surgery

Using high-speed ocular coherence tomography (OCT) systems, we have developed new methods to
image and measure optic nerve head (ONH) and retinal blood flow. Preliminary results have
shown that visual field (VF) loss is more highly correlated with retinal blood flow as
measured by OCT than any neural structure measured by OCT or other imaging modality.
Accordingly, the goal of the proposed project is to improve the diagnostic and prognostic
evaluation of glaucoma by further developing novel functional OCT measurements using
ultrahigh-speed (70-100 kHz) OCT technology.

Retinal blood flow, ONH circulation, optic disc rim volume, peripapillary nerve fiber layer
volume, and macular ganglion cell complex volume are all pieces of the same glaucoma puzzle.
This project will develop novel imaging methods that allow us to look at the whole picture
using one tool - ultrahigh-speed OCT.

Inclusion Criteria:

- Subjects diagnosed with perimetric open angle glaucoma or chronic angle closure
glaucoma.

- Subjects scheduled to undergo trabeculectomy or tube shunt surgery

Exclusion Criteria:

- Best-corrected visual acuity less than 20/40

- Age < 18 or >80 years

- Refractive error of > +3.00 D or < -7.00 D

- Previous vision correction surgery such as Laser-Assisted in situ Keratomileusis
(LASIK) or Photorefractive Keratectomy (PRK)

- Previous intraocular surgery except for uncomplicated cataract extraction with
posterior chamber intraocular lens implantation

- Diabetic retinopathy

- History of heart failure, myocardial infarction, transient ischemic attack or stroke

- Other diseases that may cause VF loss or optic disc abnormalities

- Inability to clinically view or photograph the optic discs due to media opacity or
poorly dilating pupil

- Inability to perform reliably on automated VF testing

- Life-threatening or debilitating illness making it unlikely patient will successfully
complete the study.

- Refusal of informed consent or of commitment to the full length of the study