Digital indocyanine green angiography in anterior ischemic optic neuropathy

Purpose. Anterior ischemic optic neuropathy (AION) is presumed to result from vascular insufficiency of the optic nerve, but the specific location of the insult has not been determined. We evaluated the small vessels of the optic nerve head and peripapillary choroid by optical sectioning using confocal tomographic angiography (CTA) using indocyanine green. Methods. CTA was performed in twelve patients with acute (less than one month) AION. The angiographic data was analyzed using image processing software and compared to age matched patients with no optic nerve pathology. Result. Sectorial delay or absence of dye filling in all sections of the optic disc was found in eyes with AION. Segments with dilated leaking capillaries causing early hyperfluorescence were seen adjacent to non filling sectors. The filling pattern of the peripapillary choroid was patchy and similar to that of eyes without optic nerve disease. Conclusions. CTA with indocyanine-green in AION demonstrates sectonal delayed filling of the optic nerve head. The filling pattern of the peripapillary choroid did not differ from that of controls.