FLUORESCEIN FILLING DEFECTS OF THE OPTIC DISC IN NORMAL TENSION GLAUCOMA
N. Plange, O. Arend, A. Harris1, M.Wenzel, A. Remky
Purpose: Analysis of clinical importance of the size of filling defects in fluorescein angiograms in normal tension glaucoma (NTG) in comparison to visual field loss, vascular diameters and retinal hemodynamics.
Methods: 32 patients (m 9, f 23, mean age 58.9 years, no vasoactive systemic or topical therapy) with NTG were included in this study. In digitized video fluorescein angiograms (Scanning Laser Ophthalmoscope) the size of absolute filling defects of the optic disc and arterial diameters were quantified in the venous phase. Furthermore, arteriovenous passage time (AVP) was determined. Visual fields were obtained by automatic static perimetry (Humphrey w-w) and graded in stages of glaucoma visual field defects (Aulhorn I-V). Results: The filling defects correlated with the glaucoma visual field loss stages of Aulhorn (p<0.05) and with arterial diameters (R= -0.61, p<0.05). There was no correlation with the AVP.
Conclusion: The size of fluorescein filling defects may be useful as a parameter in the evaluation of glaucoma-induced visual field loss. The results support the hypothesis that in NTG disturbances of the circulation result in filling defects of the optic disc and visual field loss.
Supported by START 4/96-4, NIH grant EY10180-01; Research to Prevent Blindness, Indiana
University Augenklinik der RWTH Aachen, Pauwelsstr.30, 52057 Aachen.
1Dep of Ophthalmology, Indiana University, Indianapolis, USA