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      Detection of Zinn-Haller arterial ring in highly myopic eyes by simultaneous indocyanine green angiography and optical coherence tomography.

      American Journal of Ophthalmology
      Adult, Aged, Aged, 80 and over, Ciliary Arteries, pathology, Coloring Agents, diagnostic use, Female, Fluorescein Angiography, Fundus Oculi, Humans, Indocyanine Green, Male, Middle Aged, Myopia, Optic Disk, blood supply, Retrospective Studies, Tomography, Optical Coherence, methods

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          Abstract

          To determine the intrascleral location of the circle of Zinn-Haller by simultaneous indocyanine green (ICG) angiography and enhanced-depth imaging optical coherence tomography (EDI-OCT) in highly myopic eyes. Retrospective, consecutive, observational case series. Ninety-four eyes of 67 consecutive patients with pathologic myopia who underwent simultaneous ICG angiography and EDI-OCT examinations by Spectralis HRA-OCT, and whose Zinn-Haller ring was observed within the area of myopic conus by ICG angiography, were studied. The definition of pathologic myopia was a refractive error (spherical equivalent) <-8.00 diopters (D) or an axial length >26.5 mm. The EDI-OCT images showed cross-sections of the vessels that were identified in the ICG images as the circle of Zinn-Haller. The vessels were seen as a hyporeflective circle within the peripapillary sclera. An intrascleral course of the Zinn-Haller ring was clearly observed in adjacent serial OCT sections. The filling of the Zinn-Haller ring was from the short posterior ciliary arteries, and OCT also showed a continuous pathway from the retrobulbar short posterior ciliary arteries to the circle of Zinn-Haller. Centripetal branches were seen to run toward the optic nerve from the Zinn-Haller ring in 20 eyes by ICG and were confirmed by OCT in 4 eyes. The HRA-OCT images confirmed that the vascular structure surrounding the optic disc observed by ICG angiography had topographic features specific to the Zinn-Haller arterial ring by OCT. The in situ observation of the circle of Zinn-Haller by simultaneous ICG angiography and OCT is a useful method to examine the Zinn-Haller ring in eyes with pathologic myopia. Copyright © 2013 Elsevier Inc. All rights reserved.

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