Choroidal filling of parapapillary area in glaucoma : an evaluation with Icga

Purpose: To evaluate the angiographic pattern of parapapillary area using high speed dynamic indocyanine green angiography in normal, ocular hypertensive (OHT) and primary open angle glaucoma (POAG) eyes. Methods: A concentric parapapillary area 450m wide,adjacent to the prelaminar and laminar vascular territory, was studied using high speed dynamic indocyanine green angiography performed with Scanning Laser Ophthalmoscope (Heidelberg HRA Ottobrun Germany), in 20 normal subjects, 20 OHT and 20 POAG patients. The 3 groups were matched by age. Patients with peripapillary atrophy were excluded. Three well-trained evaluators independently assessed the initial and the maximum choroidal filling times in the parapapillary area. Each eye was assessed 3 times by each evaluator in order to calculate inter- and intra-observer agreement. Filling dynamic was compared in the three groups. Results: Mean initial and maximum choroidal filling times were respectively 24.52 sec. (sd 6.3) and 32.47 sec. (sd 7.5) in POAG patients, 17.25 sec. (sd 2.8) and 22.26 (sd 3.2) in OHT patients, and 15.74 sec. (sd 1.8) and 21.85 sec. (sd 1.2) in normals (p< 0.01, ANOVA). Intra- and inter-observer agreement was high: mean standard deviations were 0.21 sec and 0.24 sec (intra-observer) and 0.32 sec and 0.68 sec (inter-observer) for initial and maximum filling respectively. Conclusions: A parapapillary choroidal filling delay was observed in POAG patients as compared with OHT patients and normals. The interval between the appearance of the dye and maximum filling did not significantly vary in the 3 groups possibly indicating the involvement of the deeper components of the optic nerve head blood supply.