Correlation between vascularization of the optic nerve head and visual fields

Purpose. The importance of the optic nerve head (ONH) perfusion in the mechanism of injury of the optic nerve in glaucoma is still unknown. The vasculature of the ONH can be demonstrated by confocal ICG angiography (ICGA). The purpose of the study was to investigate whether the in vivo microcirculation of the ONH can be correlated to the function of the optic nerve, as evaluated by visual field tests. Methods. ICGA was performed in 50 glaucomatous and 20 non glaucomatous patients. The distribution pattern of the microcirculation of the ONH was evaluated by two readers. Visual fields were analyzed separately in a masked fashion. Results. A diffuse microvascular filling pattern of the ONH with no filling defects was apparent in eyes with normal visual field. Localized filling defects in the microcirculation of the ONH were associated with field defects. Diffuse absence of the microcirculation (except a small temporal sector) was associated with a tubular vision. Conclusions. ONH perfusion as demonstrated by ICGA correlated with visual field results.