Abstract
Recent studies reported that parapapillary microvascular dropout (MvD) was significantly associated with glaucoma and glaucoma progression. To understand the clinical relevance/importance of MvD, it is essential to know the exact vascular anatomy of optic nerve head (ONH). Although it is known that parapapillary choroid and the deep ONH structure including prelaminar tissue are both supplied by branches of short posterior ciliary artery, it remains controversial whether parapapillary choroid provides a major contribution to the prelaminar tissue perfusion. This study investigated perfusion within and around the ONH using indocyanine green angiography. Thirty-three eyes from 33 patients with primary open-angle glaucoma and 10 eyes from 10 normal subjects were included. The temporal sequence of dye appearance in various tissues was analyzed. We also sought the microvessels directly responsible for blood supply to the prelaminar tissue. The perfusion of the prelaminar tissue, which occurred in a sectoral fashion, was dependent on the dye appearance in the adjacent parapapillary choroid. In addition, microvessels crossing over the optic disc margin from the parapapillary choroid to the ONH were found. The findings suggest that the centripetal flow from the parapapillary choroid is an important source of prelaminar tissue perfusion.
Highlights
Short posterior ciliary artery (SPCA) supplies the prelaminar tissue and the lamina cribrosa of the ONH15
The intracorrelation coefficients (ICC) were 0.999 for parapapillary choroidal arteriole, 0.992 for cilioretinal artery, 0.999 for microvessels crossing from the choroid to the optic nerve head (ONH), 0.998 (0.994–0.999) for central retinal artery (CRA), and 0.997 for peak intrapapillary filling
The temporal sequence of first dye appearance in the retinal, choroidal and ciliary artery was diverse among subjects
Summary
Short posterior ciliary artery (SPCA) supplies the prelaminar tissue and the lamina cribrosa of the ONH15. Controversy remains regarding the blood supply to the prelaminar tissue at the microvascular level. Some reports contended that the peripapillary choroid is the primary supply to the prelaminar region of the ONH15,16. Others have asserted that parapapillary choroid had no or minimally significant role in the blood supply of the ONH17–19. Given the association of MvD with glaucoma, it is important to establish the microvascular anatomy of the prelaminar tissue supply. Such knowledge may provide a platform to enhance the insight on the relevance of MvD with glaucoma. The purpose of this study was to evaluate the anterior ONH blood supply using ICGA which enables high resolution imaging of the microvasculature
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
