CONFOCAL TOMOGRAPHIC ANGIOGRAPHY OF THE OPTIC-NERVE HEAD IN PATIENTS WITH GLAUCOMA

PURPOSE: To demonstrate the superficial and deep blood supply of the o ptic nerve using a new method, confocal tomographic angiography, which combines two new techniques, confocal laser scanning ophthalmoscopy a nd indocyanine green angiography, into one system. METHODS: In a prosp ective study using confocal tomographic angiography, we evaluated the correlation between the vascular supply of: the optic nerve and that o f the visual field in 90 eyes of 49 subjects (25 eyes of 20 subjects w ith normal visual field and 65 glaucomatous eyes of 39 subjects with v isual field defects; 10 subjects each had one eye with normal visual f ield and one with visual field defects), RESULTS: In 22 of 25 eyes wit h a normal visual field, a diffuse microvascular filling pattern of th e optic disk area was apparent with no filling defects, The confocal t omographic angiography of 49 of 65 glaucomatous eyes had good correlat ion with their visual field defect location, In 20 of 27 eyes with sup erior visual field loss, an inferior vascular filling defect was detec ted, In 10 of 13 eyes with inferior visual field loss, a superior vasc ular filling defect was detected, In 10 of 15 eyes with superior and i nferior visual field loss, inferior and superior vascular filling defe cts were detected, Finally, in nine of 10 eyes with total visual held loss, no vascularity of the optic disk could be detected. CONCLUSION: Confocal tomographic angiography is a new imaging technology that may be applied for the evaluation of the vascular supply of the optic nerv e head. (C) 1998 by Elsevier Science Inc. All rights reserved.