Increased fluorescein filling defects in the wall of the optic disc cup in glaucoma

One hundred seventy-one optic disc fluorescein angiograms of glaucomatous, ocular hypertensive, and normal patients were studied for the occurrence of areas of hypofluorescence or absolute filling defects in the rim, wall, and floor of the optic cup using disc stereo photographs compared with the fluorescein angiogram. The frequencies of involvement of the rim, wall, and floor of the cup by filling defects were determined. The wall of the cup has a greater percentage of filling defects in subjects with glaucoma than in ocular hypertensive or in normal subjects. The floor of the cup has more filling defects in normal subjects than in those with glaucoma. The involvement of the wall of the cup increases with the degree of visual-field loss in glaucoma. We suggest that, in glaucoma, the effect of ocular pressure is greater on the wall of the cup than on the floor of the cup.