Potential diagnostic value of fluorescein angiography and color Doppler imaging in primary open angle glaucoma.

PURPOSE: To evaluate absolute filling defects of the optic disc and color Doppler imaging (CDI) measurements in primary open angle glaucoma (POAG) to assess their diagnostic potentialities.

METHODS

Twenty patients with POAG and 20 age- and sex-matched controls were included in this study. Fluorescein angiograms were performed and percentage of absolute fluorescein filling defects was calculated. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive indices (RI) of the ophthalmic artery (OA), central retinal artery (CRA), and temporal and nasal short posterior ciliary arteries (TPCA, NPCA) were measured using CDI.

RESULTS

Absolute filling defects of the optic nerve head and RI of CRA were significantly larger in patients with POAG (p<0.001). EDV of CRA, TPCA, and NPCA were significantly reduced in POAG (p<0.05). RI of OA, TPCA, and NPCA were significantly increased in patients with POAG (p<0.05). Absolute fluorescein filling defects percentages correlated with the RI of CRA and NPCA. They correlated negatively with EDV of CRA, NPCA, and TPCA. The diagnostic accuracy of the RI of CRA in glaucoma was 96% while that of absolute fluorescein filling defects percentages was 92%.

CONCLUSIONS

The combination of different techniques allows further interpretation of ocular circulatory changes in glaucoma and help in diagnosis of glaucoma. Further studies are needed for better understanding of the relationship between circulatory and neural loss.