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Abstract #19015 Published in IGR 3-1
Absolute filling defects of the optic disc in fluorescein angiograms in glaucoma: a retrospective clinical study
Plange N; Remky A; Arend OKlinische Monatsblätter für Augenheilkunde 2001; 218: 214-221
BACKGROUND: Analysis of the clinical importance of the size of filling defects in fluorescein angiograms in primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), ocular hypertension, and subjects with physiological excavations in comparison to visual field loss, optic nerve head morphology, and hemodynamics. PATIENTS AND METHODS: Seventy-five patients (POAG, NTG, ocular hypertension) and ten healthy subjects with physiological excavations were included in this study. In digitized video fluorescein angiograms (Scanning laser Ophthalmoscope), the size of absolute filling defects of the optic disc was quantified in the early venous phase, and expressed by percentage of the optic disc. Visual fields were obtained by conventional static perimetry (Humphrey 24-2) and graded in stages of glaucoma visual field defects (Aulhorn I-V). Optic disc excavations were evaluated as cup-to-disc area ratios. RESULTS: The filling defects correlated with the visual-field loss stages of Aulhorn and the visual field indices mean deviation (MD), pattern standard deviation (PSD), and corrected PSD (CPSD). There was no correlation with the index short-term fluctuation (SF) or with systemic hemodynamics (blood pressure, perfusion pressure) or intraocular pressure. Absolute filling defects correlated with the cup-to-disc area ratio in NTG. The absolute filling defects were larger in patients with glaucoma (POAG, NTG) compared to patients without glaucomatous visual field loss (ocular hypertension, glaucoma-like discs). No difference of filling defects was found in the glaucoma group (POAG, NTG). Patients with NTG had larger excavations and lower systolic blood pressures than patients with POAG. CONCLUSIONS: The size of fluorescein filling defects may be useful as a parameter for the evaluation of ischemic lesions of the optic nerve head. Absolute filling defects may differentiate POAG from ocular hypertension and NTG from glaucoma-like discs without field defects. These results support the hypothesis that, in POAG and NTG, disturbances of the circulation result in similar filling defects of the optic disc, and visual field loss. LA: German
Dr N. Plange, Universitäts-Augenklinik der RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany
Classification:
6.8.2 Posterior segment (Part of: 6 Clinical examination methods > 6.8 Photography)
