Jin, Eric

ABSTRACT Background The adoption of angle‐based minimally invasive glaucoma surgery (MIGS) procedures has accelerated in recent years; however, inherent limitations remain. Imaging‐based techniques across the pre‐, intra‐ and post‐operative stages of surgery may facilitate patient selection and improve surgical outcomes. This systematic review explores the application of imaging‐based techniques to visualise aqueous humour outflow (AHO) in angle‐based MIGS. Methods A literature search was performed on PubMed, EMBASE and Cochrane Library from inception to 16 February 2025. Cohort, cross‐sectional and observational studies reporting the use of imaging‐based techniques to visualise AHO in angle‐based MIGS were included in this review. Results An initial 393 studies were identified, with 21 studies included in final analysis. Imaging techniques reported in literature included various methods to directly observe episcleral veins, haemoglobin venous imaging (HVI), fluorescein and indocyanine green (ICG) aqueous angiography, channelogram and anterior segment optical coherence tomography angiography (AS‐OCTA). Visualisation of AHO pre‐ and intra‐operatively may predict surgical outcomes, aiding in patient selection and surgical prognostication. Intra‐operative imaging may facilitate targeted placement of MIGS in areas of initially angiographically low or high areas of AHO. AHO assessment pre‐, intra‐ and post‐operatively may allow comparative analysis of surgical success and efficacy across various angle‐based MIGS. Conclusions Imaging‐based techniques visualising AHO have significant potential to improve surgical outcomes of angle‐based MIGS.

A systematic review was conducted of studies published up to 30 August 2024. Studies comparing conventional visual field (VF) indices, ability to detect central visual field defects (CVFDs), structure–function (S-F) concordance, and test characteristics across the HVF 24-2C SITA-Faster, 24-2 SITA-Standard/Faster, and 10-2 SITA-Standard/Fast tests were included. Eight studies with 1239 subjects (49.1% male; mean age, 54.8–66.9 years) were analyzed. The 24-2C produced similar global VF indices compared to the 10-2 and 24-2 (Standard/Faster) (ICC = 0.95 and 0.80, p < 0.001), detected more VF defects and CVFD clusters, and demonstrated greater S-F concordance than the 24-2 (Standard/Faster). Although the 10-2 (Standard/Fast) detected significantly more CVFDs and had a greater S-F concordance, the agreement between the 24-2C and 10-2 grids was substantial (ĸ = 0.488 to 0.708). The 24-2C was also faster compared to the 24-2 Standard and 10-2 (Standard/Fast), with comparable false positives, higher false negatives, and fewer fixation losses than the 24-2 Standard. In conclusion, the HVF 24-2C is quicker and identifies more CVFDs than the 24-2 grid, demonstrates high agreement with the 10-2 grid, and aids in CVFD screening.