Iris indocyanine green angiography in pseudoexfoliation syndrome and capsular glaucoma

Abstract

ABSTRACT.Purpose: The iris vasculature shows typical changes in pseudoexfoliation syndrome (PXS) revealed by iris fluorescein angiography (IFA), such as hypoperfusion, microneovascularisation, and anastomotic vessels. Iris indocyanine green angiography (IICGA) can visualize more precisely details of the iris vascular pattern, especially as regards hypoperfusion and capillary dilatations. The aim of the present study is to describe the angiographic features of PXS on IFA and IICGA, comparing eyes affected with those not affected by capsular glaucoma. Methods: In a prospective study 42 consecutive patients affected by PXS underwent a complete ophthalmologic examination including IFA and IICGA. Thirty-two eyes were affected by capsular glaucoma. IICGA was performed using IMAGEnet System H1024. Results: IFA can easily detect the microneovascularisation, whereas IICGA allows a better recognition of iris hypoperfusion and anastomotic vessels, and it can reveal iris pigment epithelium defects. While the degree of hypoperfusion was similar in the two subgroups, eyes affected by capsular glaucoma more frequently showed signs of both microneovascularisation (marked stromal tufts and marked plexi), and of anastomotic vessels (peripheral loop, lesser circle and oblique vessels), with statistically significant difference. A clear correlation between hypoperfusion, microneovascularisation, and anastomotic vessels as regards site and extent was not noticed. Conclusions: A different angiographic pattern can be detected in PXS eyes with capsular glaucoma in comparison with eyes without it. Further studies are needed to correlate angiographic features revealed by IFA and IICGA, with clinical features.Key words: pseudoexfoliation syndrome -iris fluorescein angiography -iris indocyanine green angiography.

The spectrum of iris angiography abnormalities in pseudoexfoliation syndrome

“…10,11 In the current investigation, we have tried to assess if there is a gradual progression of the severity of microvascular abnormalities in the different stages of the disease. The results of quantitative analyses show that unaffected, affected, and bilateral groups are quite similar, whereas eyes affected by PES glaucoma have more severe involvement.…”

“…1,2 The reported histological changes are the morphological correlate of the blood-aqueous barrier (BAB) breakdown, which can be studied by means of several techniques, including fluorophotometry, 3 laser flare-cell meter, [4][5][6] immunohistochemical tracer, 7 and iris angiography. 3,[8][9][10][11] Typical features of PES on iris angiography are hypoperfusion, microneovascularizations, and anastomotic vessels. 3,[9][10][11] Comparison between iris fluorescein angiography (IFA) and iris indocyanine green angiography (IICGA) has shown that IICGA is superior in disclosing iris hypoperfusion and anastomotic vessels, whereas IFA allows a more precise detection of microneovascularizations.…”

“…3,[8][9][10][11] Typical features of PES on iris angiography are hypoperfusion, microneovascularizations, and anastomotic vessels. 3,[9][10][11] Comparison between iris fluorescein angiography (IFA) and iris indocyanine green angiography (IICGA) has shown that IICGA is superior in disclosing iris hypoperfusion and anastomotic vessels, whereas IFA allows a more precise detection of microneovascularizations. 10,11 Nevertheless, no study has tried to correlate the iris vascular changes with the different clinical manifestations of PES.…”

“…3,[9][10][11] Comparison between iris fluorescein angiography (IFA) and iris indocyanine green angiography (IICGA) has shown that IICGA is superior in disclosing iris hypoperfusion and anastomotic vessels, whereas IFA allows a more precise detection of microneovascularizations. 10,11 Nevertheless, no study has tried to correlate the iris vascular changes with the different clinical manifestations of PES. The aims of the present study are to compare the spectrum of quantitative and qualitative angiographic features in patients monolaterally or bilaterally affected by PES and to evaluate the sensibility and specificity of these features in the diagnosis of PES glaucoma.…”

Nailfold capillary morphology in exfoliation syndrome

“…Fluorescein angiography reveals hypoperfusion, apparent microneovascularization, fluorescein leakage, and vascular anastomosis of iris vessels. [7][8][9][10][11] There is apparent microneovascularization of the limbus as well as ectasia and tortuosity of ciliary vessels. 12 Central retinal vein occlusions occur more commonly in XFS vs controls.…”