Optociliary veins in optic nerve sheath meningioma: Indocyanine green videoangiography findings

Objective: To report the indocyanine green videoangiography (ICG-V) characteristics of optociliary veins (OV) in optic nerve sheath meningioma (ONSM). Design: Case series. Participants: Four eyes (patients) with OV and ONSM were examined. Intervention: Indocyanine green videoangiography and intravenous fluorescein angiography (IVFA) were prospectively performed. Main Outcome Measures: The course of OV in ONSM cases was observed with ICG-V and IVFA. Results: On ICG-V, the course of OV was followed from their origin at small tributaries of the central retinal vein, their junction with choroidal veins, and finally to their drainage in the vortex venous system. The authors found an inverse relationship between the degree of optic disc edema and the development and ease of visualization of the optociliary veins and their draining course through the choroidal circulation. The mean time from the injection of indocyanine green to the visualization of OV's draining choroidal vessels was 35.4 seconds (range, 25.4-50 seconds). Intravenous fluorescein angiography allowed visualization of OV only at the margins of the optic disc in all cases. Conclusion: Indocyanine green videoangiography provides important and new information in cases with OV and ONSM that is not obtained with IVFA. Such information may provide important knowledge regarding the hemodynamics of the choroidal circulation in normal and pathologic states.