Indocyanine green angiography of retrobulbar vascular structures in severe myopia.
OBJECTIVE
To evaluate angiographic findings of retrobulbar arteries and veins in severely myopic patients.


METHODS
We examined 416 severely myopic eyes (213 patients) with refractive errors greater than -8.25 diopters using indocyanine green videoangiography. A control group of 74 eyes (37 patients) had refractive errors within plano +/- 3 diopters. Four severely myopic patients underwent computed tomographic angiography to identify the entire intraorbital course of retrobulbar veins.


RESULTS
Of 416 severely myopic eyes, 231 (55.5%) exhibited retrobulbar arteries, which were tortuous and pulsatile behind the posterior pole of the globe. Retrobulbar arteries connected directly with choroidal arteries temporal to the macular area. In 17 of these 231 eyes, retrobulbar arteries were also observed nasal to the optic nerve head, continuous with the Zinn-Haller ring around the optic nerve head and directly connected with choroidal arteries. In 39 severely myopic eyes (31 patients), indocyanine green angiography disclosed retrobulbar veins, most of which coursed vertically just behind the posterior pole of the globe. These retrobulbar veins originated as an inferior vascular network of the inferior orbital vein and drained into the superior orbital vein in the upper orbit.


CONCLUSIONS
Retrobulbar arteries observed in this study were temporal and nasal short posterior ciliary arteries. Only the lateral collateral vein, which was one of the collateral channels between the superior and inferior orbital veins, was visible in severely myopic eyes. Indocyanine green angiography is useful in evaluating retrobulbar vascular structure in severely myopic eyes.
Ohno-Matsui
K
K
Department of Ophthalmology, School of Medicine, Tokyo Medical and Dental University, Japan.
Morishima
N
N
Ito
M
M
Yamashita
S
S
Futagami
S
S
Tokoro
T
T
Nakagawa
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D009216:Myopia / Q000150:complications* / Q000503:physiopathology; D009915:Orbit / Q000098:blood supply* / Q000000981:diagnostic imaging; D012039:Regional Blood Flow / Q000502:physiology; D012161:Retinal Artery / Q000000981:diagnostic imaging / Q000502:physiology; D012169:Retinal Vein / Q000000981:diagnostic imaging / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green