Abstract
Abstract: :
Purpose: To quantify and identify the time course of capillary fluorescein leakage of the optic disc in open–angle glaucoma (POAG) and controls. Methods: 20 patients with POAG (aged 58 ±10 years) and 14 age–matched controls (aged 51 ±12 years) were included in this prospective study. Fluorescein leakage of the optic disc was quantified using digital image analysis. A leakage ratio (fluorescence of the optic disc versus fluorescence of the surrounding retina) was defined and fluorescein leakage of the optic disc was quantified at 7–8 min, 9–10 min, 11–12 min, and 13–14 min after injection of the fluorescein dye. Results: The fluorescein leakage exhibited a significant different time course with higher leakage ratio values in POAG compared to controls (p=0.004, ANOVA repeated measures). The relative change in optic disc fluorescence from 7–8 min to 9–10 min was significantly higher in POAG compared to controls (Mann–Whitney U, p=0.002). Patients with POAG exceeding normal leakage range at 9–10 min (mean ± 2 standard deviations, i.e. leakage ratio >1.39, n=7) showed significant higher intraocular pressure values at the time of angiography (p=0.009), whereas visual field global indices, systemic blood pressure and perfusion pressure did not differ significantly. Conclusions: The time course of fluorescein leakage is significantly different in POAG. Patients with POAG exhibit a higher increase of capillary fluorescein leakage until 10 minutes after injection of the fluorescein dye. Higher intraocular pressure is associated with increased optic disc leakage in POAG. Increased fluorescein leakage may reflect endothelial dysfunction of the optic disc related to increased vascular permeability.
Keywords: optic disc • optic flow