[The significance of ciliary circulation in the development of iris neovascularisation (author's transl)]

Three cases of peripapillary choroidal filling defects demonstrated by fluorescein angiography are presented. In two cases the defect was interpreted as an occlusion of a posterior ciliary artery. One of these patients had neovascularization of the iris and ischemia of the upper half of the retina. Later a contralateral hemiplegia developed. The other patient had no other known vascular disease of the eye except occlusion of the posterior ciliary artery by giant cell arteritis. One patient had underfilling of the peripapillary choroid which was interpreted as insufficiency of the ciliary circulation; he had neovascularization of the iris, a nonperfused area in the retina and extensive microangiopathy due to arterial hypertension. It was concluded that ciliary hypoxia is the cause of iris and papillary neovascularization. Occlusion of one posterior ciliary artery is not enough to decompensate anterior segment circulation, unless other high risk factors such as carotid insufficiency or arterial hypertension are present.