INDOCYANINE GREEN ANGIOGRAPHY OF THE PERIPAPILLARY REGION IN GLAUCOMATOUS EYES BY CONFOCAL SCANNING LASER OPHTHALMOSCOPY

PURPOSE: To investigate the peripapillary region in glaucomatous eyes by indocyanine green angiography. METHODS: Indocyanine green angiograp hy of the optic disk and peripapillary region was evaluated by modifie d confocal scanning laser ophthalmoscopy in 22 eyes of 22 patients wit h glaucoma and in 10 normal eyes of 10 control patients with unilatera l choroidal melanoma. The occurrence and extent of indocyanine green a ngiographic anomalies were correlated with optic disk morphology and t he severity of glaucoma. RESULTS: In the 32 eyes of 32 patients, two t ypes of peripapillary defects were identified in the late-phase angiog rams. The first was hypofluorescent areas in the peripapillary region and was more common in eyes with glaucoma (P < .02); their occurrence and extent correlated with age (P < .01). In nine of the 17 eyes, alph a (peripheral) zone peripapillary atrophy corresponded with the areas of peripapillary indocyanine green hypofluorescence. The second defect , hypofluorescent halos adjacent to and extending around the full circ umference of the optic disk margins, did not correlate with any of the study factors. CONCLUSIONS: Indocyanine green angiography showed area s of hypofluorescence in the peripapillary region in late-phase angiog rams in 68% of glaucomatous eyes compared with 20% of control eyes. Th ese hypofluorescent areas might be either the result of blockage of ba ckground fluorescence by pigment or caused by an absence of vascular t issue (choriocapillaris).