Indocyanine green angiography of the peripapillary region in glaucomatous eyes by confocal scanning laser ophthalmoscopy.

PURPOSE

To investigate the peripapillary region in glaucomatous eyes by indocyanine green angiography.

METHODS

Indocyanine green angiography of the optic disk and peripapillary region was evaluated by modified confocal scanning laser ophthalmoscopy in 22 eyes of 22 patients with glaucoma and in 10 normal eyes of 10 control patients with unilateral choroidal melanoma. The occurrence and extent of indocyanine green angiographic anomalies were correlated with optic disk morphology and the severity of glaucoma.

RESULTS

In the 32 eyes of 32 patients, two types of peripapillary defects were identified in the late-phase angiograms. The first was hypofluorescent areas in the peripapillary region and was more common in eyes with glaucoma (P < .02); their occurrence and extent correlated with age (P < .01). In nine of the 17 eyes, alpha (peripheral) zone peripapillary atrophy corresponded with the areas of peripapillary indocyanine green hypofluorescene. The second defect, hypofluorescent halos adjacent to and extending around the full circumference of the optic disk margins, did not correlate with any of the study factors.

CONCLUSIONS

Indocyanine green angiography showed areas of hypofluorescene in the peripapillary region in late-phase angiograms in 68% of glaucomatous eyes compared with 20% of control eyes. These hypofluorescent areas might be either of result of blockage of background fluorescence by pigment or caused by an absence of vascular tissue (choriocapillaris).