title: Aqueous Angiography-Mediated Guidance of Trabecular Bypass Improves Angiographic Outflow in Human Enucleated Eyes.
abstract: To assess the ability of trabecular micro-bypass stents to improve aqueous humor outflow (AHO) in regions initially devoid of AHO as assessed by aqueous angiography.
  
  
  
  Enucleated human eyes (14 total from 7 males and 3 females [ages 52-84]) were obtained from an eye bank within 48 hours of death. Eyes were oriented by inferior oblique insertion, and aqueous angiography was performed with indocyanine green (ICG; 0.4%) or fluorescein (2.5%) at 10 mm Hg. With an angiographer, infrared and fluorescent images were acquired. Concurrent anterior segment optical coherence tomography (OCT) was performed, and fixable fluorescent dextrans were introduced into the eye for histologic analysis of angiographically positive and negative areas. Experimentally, some eyes (n = 11) first received ICG aqueous angiography to determine angiographic patterns. These eyes then underwent trabecular micro-bypass sham or stent placement in regions initially devoid of angiographic signal. This was followed by fluorescein aqueous angiography to query the effects.
  
  
  
  Aqueous angiography in human eyes yielded high-quality images with segmental patterns. Distally, angiographically positive but not negative areas demonstrated intrascleral lumens on OCT images. Aqueous angiography with fluorescent dextrans led to their trapping in AHO pathways. Trabecular bypass but not sham in regions initially devoid of ICG aqueous angiography led to increased aqueous angiography as assessed by fluorescein (P = 0.043).
  
  
  
  Using sequential aqueous angiography in an enucleated human eye model system, regions initially without angiographic flow or signal could be recruited for AHO using a trabecular bypass stent.
authors: Doheny Eye Institute, Los Angeles, California, United States 2Department of Ophthalmology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, United States.
authors: Alex S
authors: AS
authors: Huang
authors: Doheny Eye Institute, Los Angeles, California, United States.
authors: Sindhu
authors: S
authors: Saraswathy
authors: Doheny Eye Institute, Los Angeles, California, United States.
authors: Anna
authors: A
authors: Dastiridou
authors: Department of Ophthalmology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, United States.
authors: Alan
authors: A
authors: Begian
authors: Doheny Eye Institute, Los Angeles, California, United States.
authors: Chirayu
authors: C
authors: Mohindroo
authors: Doheny Eye Institute, Los Angeles, California, United States 2Department of Ophthalmology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, United States.
authors: James C H
authors: JC
authors: Tan
authors: Doheny Eye Institute, Los Angeles, California, United States 2Department of Ophthalmology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, United States.
authors: Brian A
authors: BA
authors: Francis
authors: Department of Ophthalmology and Pathology, University of Southern California, Los Angeles, California, United States.
authors: David R
authors: DR
authors: Hinton
authors: Hamilton Glaucoma Center and Shiley Eye Institute, University of California-San Diego, San Diego, California, United States.
authors: Robert N
authors: RN
authors: Weinreb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000000981:diagnostic imaging / Q000378:metabolism*; D002102:Cadaver; D004396:Coloring Agents / Q000493:pharmacokinetics; D015353:Eye Enucleation; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D005901:Glaucoma / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D015607:Stents; D041623:Tomography, Optical Coherence; D014129:Trabecular Meshwork / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000601:surgery; D014741:Video Recording
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green