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Widespread choroidal insufficiency in primary open-angle glaucoma
1School of Optometry, University of New South Wales, Kensington, Australia.
Journal of Glaucoma
|February 1, 1997
Summary
Glaucoma patients exhibit thinner choroids due to loss of inner vessels, impacting choroidal perfusion. This finding, observed in primary open-angle glaucoma, was confirmed using histological and angiographic methods.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Vascular Biology
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Choroidal blood flow alterations are implicated in glaucoma pathogenesis.
- Understanding choroidal changes is crucial for glaucoma diagnosis and treatment.
Purpose of the Study:
- To investigate choroidal perfusion in primary open-angle glaucoma (POAG).
- To utilize histological and angiographic techniques to assess choroidal vasculature.
- To compare choroidal characteristics between glaucoma, optic atrophy, and normal eyes.
Main Methods:
- Examined choroidal vasculature in clinicopathological slides from 25 POAG, 5 optic atrophy, and 18 normal eyes.
- Measured choroidal thickness and vessel dimensions using light microscopy and image analysis.
- Compared fluorescein angiographic measures, including peak choroidal filling time, in 78 glaucoma and 84 normal eyes.
Main Results:
- Choroids were significantly thinner (approx. 50 microns) in glaucoma patients compared to normal or optic atrophy eyes.
- Vessel frequency and diameter decreased most notably near the choriocapillaris in glaucoma.
- Peak choroidal filling time was significantly delayed in glaucoma patients, independent of age.
Conclusions:
- Reduced choroidal thickness in POAG is primarily attributed to the loss of innermost choroidal vessels.
- Glaucoma-associated choroidal changes involve size decrease without significant flattening.
- These distinct choroidal changes in POAG correlate with delayed perfusion observed in angiography and are not present in optic atrophy alone.