Peripapillary fluorescein angiographic findings in primary open angle glaucoma

Detailed fluorescein angiographic findings in the disc circumference may be useful for evaluating the possible relation of the circumference to glaucomatous nerve damage.

Fluorescein angiograms of 25 eyes of 25 subjects with primary open angle glaucoma were observed after they had undertaken Octopus perimetry. Based on the retinotopic projection, disc sectors and corresponding visual field regions were set.

Twenty three eyes (92%) showed a zone of no fluorescence around the disc (non-fluorescent zone). Of these, the zone width of the 20 eyes that had visible ciliary vessels within the zone was wider than that of the other three eyes, and showed fluorescein diffusion from the outer boundary of the zone towards the disc. The diffusion reached the disc if the zone was narrow. In those 20 eyes, a standardised difference in the zone width of inferior temporal sector minus superior temporal sector correlated with the difference in mean loss of corresponding visual field regions (r = 0.48, p = 0.0312).

The visible ciliary vessels suggest the absence of the choriocapillaris in the non-fluorescent zone, the width of which correlated with the visual field defect and may affect the amount of the fluorescein diffusion to the disc. This suggests that the diffusion might be related to optic nerve damage in glaucoma.