Area of Peripheral Retinal Nonperfusion and Treatment Response in Branch and Central Retinal Vein Occlusion

Singer, Michael; Tan, Colin S.; Bell, Darren; Sadda, Srinivas R.

doi:10.1097/iae.0000000000000148

Cited by 97 publications

(97 citation statements)

References 18 publications

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“…The ultra wide-field imaging has a shorter image capture time and allows visualisation of significantly larger areas of the retina using less number of images compared to the conventional 7-field imaging. For example, the ultra wide-field image obtained by Optos Plc, Dumfermline, Scotland, United Kingdom covers approximately a 200 degree field of view in a single image compared to the 30 to 50 degree conventional fundus cameras and is now regularly used in clinical practice [3][4][5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…With the advent of ultra wide-field imaging, an ischemic index method has been developed to quantity non-perfusion by taking into account the much larger retinal area visualized 3 . In brief, the ischemic index method is measured as a perfused ratio or percentage of the total area of perfused retina to the total area assessed by manually delineating the boundaries of the retina that are in focus and also the perfused retina [3][4][5][6][7] . Other investigators have quantified the total area of non-perfusion by manually or software assisted delineation of the non-perfused boundaries without taking into account the total area visualized and reported the area of non-perfusion in pixels or as total disc areas 11,12 .…”

Section: Introductionmentioning

confidence: 99%

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Validation of Concentric Rings Method as a Topographic Measure of Retinal Nonperfusion in Ultra-Widefield Fluorescein Angiography

Nicholson

Vázquez-Alfageme

Ramu

et al. 2015

American Journal of Ophthalmology

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2 Structured Abstract Purpose:To validate the use of concentric rings as a method to measure topographical area of retinal non-perfusion in ultra wide-field angiography with the ischemic index method, which is the most frequently used method to measure non-perfusion in ultra widefield angiography. Design:Validation study and reliability analysis Methods:Setting: Single centre study performed at National Institute for Health Research Moorfields Biomedical Research Centre, London, United Kingdom.Study Population: 28 ultra wide-field angiogram images of eyes with central retinal vein occlusion.Observation Procedure: The concentric rings method consist of six macula centered concentric rings divided into 12 segments each. Each image was graded by five graders using both the concentric rings and the ischemic index methods. Main Outcome Measures:Agreement between the two methods was calculated using the intraclass correlation coefficient. Intertest agreement, intergrader agreement, test-retest reliability and the time taken to grade using these two methods were compared. Results:The intertest agreement between concentric rings method and ischemic index method was 0.965. The intergrader agreement was 0.910 for concentric rings method and 0.898 with the ischemic index method. The test-retest reliability was 0.975 for the rings and 0.979 for the ischemic index. Average grading time per image was 187s and 297s for concentric rings method and ischemic index method respectively, p=<0.001. Conclusion:The concentric rings method has an 'almost perfect' intergrader agreement and intertest agreement with the ischemic index method with a shorter grading time. Text IntroductionFundus fluorescein angiography (FA) remains the gold standard imaging tool for the measurement of retinal perfusion status in retinal vascular diseases. Previous seminal research papers such as the Early Treatment Diabetic Retinopathy Study 1 and the Central Vein Occlusion Study 2 classified retinal perfusion status based on the montage of overlapping 7-field FA images. However, 7-field imaging only allows visualisation of approximately a third of the retinal surface area. The acquisition of these 7-field images are also technically challenging and require well-trained photographers, well-dilated pupils and good patient co-operation to undergo multiple flash photography. Furthermore, a single 7-field montage image is formed of images acquired at different FA phases. These limitations have been overcome by the introduction of ultra wide-field imaging. The ultra wide-field imaging has a shorter image capture time and allows visualisation of significantly larger areas of the retina using less number of images compared to the conventional 7-field imaging. For example, the ultra wide-field image obtained by Optos Plc, Dumfermline, Scotland, United Kingdom covers approximately a 200 degree field of view in a single image compared to the 30 to 50 degree conventional fundus cameras and is now regularly used in clinical practice 3-9 .The conventional measurement of...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of Concentric Rings Method as a Topographic Measure of Retinal Nonperfusion in Ultra-Widefield Fluorescein Angiography

Nicholson

Vázquez-Alfageme

Ramu

et al. 2015

American Journal of Ophthalmology

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“…It has been shown to correlate directly with the presence of neovascularization, as well as the degree of macular edema and response to antivascular endothelial growth factor (anti-VEGF) treatment. 20 While the ischemic index has been helpful in the context of research analysis of wide-field angiograms, it has not found its way into the everyday practice of the typical retinal physician. In addition to visualizing the peripheral retina, ultra-wide-field imaging has been shown to accurately demonstrate macular edema and the foveal avascular zone, as measured against spectral domain OCT. 21,22 While cystoid macular edema secondary to retinal vein occlusions is classically treated with anti-VEGF injections, one case report demonstrates that wide-field guided assessment of retinal nonperfusion and corresponding TRP may break the cycle of rebound edema that often occurs when anti-VEGF injections are stopped.…”

Section: Retinal Vein Occlusionmentioning

confidence: 99%

Wide-field Imaging of Retinal Diseases

Kim¹,

Moshfeghi²

2015

US Ophthalmic Review

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125Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. Since the invention of the direct ophthalmoscope by Hermann von Helmholtz in 1851, techniques to visualize the fundus have grown exponentially both in number and sophistication. Notably, wide-field retinal imaging has taken center stage over the past 2 decades. Given its increasing popularity in research and clinical use, it is important to be aware of the different types of wide-field imaging currently available, as well as the clinical applications for, advantages, and limitations of widefield retinal imaging. This review article aims to highlight our current understanding of wide-field retinal imaging and provide an outlook for its future implications. Historical PerspectiveThe first fundus camera was developed by Frederick Dimmer at the turn of the 20th century. Dimmer was the first to incorporate fundus photography into an ophthalmic textbook, and he published the first photographic atlas in black-and-white. AbstractRetinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications. KeywordsWide-field imaging, ultra-wide-field imaging, retinal imaging, Optos, Heidelberg, fluorescein angiography, autofluorescence, diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity Disclosure: Esther Kim, MD, has no relevant conflicts of interest to declare. Andrew A Moshfeghi, MD, MBA, has been a consultant

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“…[8][9][10][11] It has also been evaluated extensively in a spectrum of other retinal diseases, particularly retinal vasculopathies. 12,13 These studies have contributed to the growing significance of peripheral findings to disease management. The ease and speed of optomap image capture makes it feasible to incorporate them into routine exams with the result that overall exam time is reduced and patient satisfaction increased.…”

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confidence: 99%

The Role of Ultra-widefield Retinal Imaging as a Standard Assessment Tool in the Cataract Practice

Assil¹,

Batra²

2017

US Ophthalmic Review

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Comprehensive evaluation of retinal health prior to and following cataract surgery is critical to supporting optimal outcomes. In addition to the importance of identifying retinal pathology that may prevent or delay cataract surgery, continuous advances in refractive intraocular lens technology and cataract surgical technique, coupled with increasingly high expectations regarding visual outcomes among younger patients, make the consideration of long-term quality of vision paramount in the cataract assessment. Optos® ultrawidefield retinal imaging supports this clinical objective by providing imaging standardization in a streamlined, patient-friendly exam process, supporting robust documentation that facilitates mapping of disease progression, and offering potential economic advantages in a resourceconstrained environment.

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Area of Peripheral Retinal Nonperfusion and Treatment Response in Branch and Central Retinal Vein Occlusion

Abstract: The area of peripheral retinal nonperfusion is variable in patients with retinal vein occlusion and affects its clinical course and response to treatment.

Cited by 97 publications

References 18 publications

Validation of Concentric Rings Method as a Topographic Measure of Retinal Nonperfusion in Ultra-Widefield Fluorescein Angiography

Validation of Concentric Rings Method as a Topographic Measure of Retinal Nonperfusion in Ultra-Widefield Fluorescein Angiography

Wide-field Imaging of Retinal Diseases

The Role of Ultra-widefield Retinal Imaging as a Standard Assessment Tool in the Cataract Practice

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