Comparison Of Choroidal Filling and Optic Nerve Head Perfusion Pattern in Glaucoma Patients with Healthy Controls

Abstract

Glaucoma is a primary cause of irreversible blindness worldwide, it kills the vision silently, having a financial burden on society regarding therapy expenses and loss of valuable hours of the day. Objective: To compare the choroidal filling time and grade the status and pattern of optic nerve head (ONH) perfusion by fundus fluorescein angiography (FFA) in glaucoma patients Methods: Patients with various types of glaucoma were enrolled and compared them with healthy volunteers with no history and findings of glaucoma. Perfusion status using FFA was studied and analyzed corresponding visual fields (VF) and optical coherence tomography (OCT) findings Results: There were 70 participants in the study, including 48 glaucoma patients and 22 healthy controls. Choroidal filling time (CFT) was 9-12, 13-17, 15-22, and 20-33 seconds in healthy individuals and patients with ocular hypertension (OH), primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG), respectively. In OH, inferonasal and inferotemporal hypofluorescence pattern of ONH perfusion was noted, whereas POAG showed an inferonasal, patchy, and undefined pattern of hypofluorescence. In contrast with the healthy volunteers that showed uniform fluorescence, patients with NTG showed inferonasal hypofluorescence. CFT was significantly delayed in NTG patients (p<0.05). We found a strong correlation between findings of FFA, OCT, and corresponding VF defects in glaucoma patients Conclusions: The choroidal filling time is prolonged in patients with various types of glaucoma, especially in cases of normal-tension glaucoma. FFA reveals perfusion defects in the form of areas of hypofluorescence and multiple characteristic optic nerve head perfusion patterns in cases of POAG, NTG, and OH.