Retinal fluorescein angiographic changes following intravitreal anti-VEGF therapy

Henaine-Berra, Andrée; García-Aguirre, Gerardo; Quiroz‐Mercado, Hugo; Martinez-Castellanos, María A.

doi:10.1016/j.jaapos.2013.12.009

Cited by 59 publications

(28 citation statements)

References 11 publications

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“…All eyes developed vascular abnormalities, similar to those described as typical ROP but with distinctive differences like venous beading, tortuosity and dilation of major retinal vessels and capillaries (“plus-like” disease), arteriovenous shunting, areas of capillary closure, abnormal capillary tufts, microaneurysms, patches (“islands”) of leaking vessels. An additional finding is the absence of avascular foveal zone which has been reported by Henaine et al [21] in 50% of patients born at 36 weeks of gestational age or more.…”

Section: Discussionmentioning

confidence: 69%

Vascular changes on fluorescein angiography of premature infants with low risk of retinopathy of prematurity after high oxygen exposure

et al. 2017

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PurposeTo describe a wide array of peripheral vascular changes using fluorescein angiography in preterm neonates, without high risk characteristics for developing retinopathy of prematurity, that were exposed to high oxygen concentration.MethodsRetrospective, two center, case series. Newborns at two different hospitals with ≥1500 g or gestational age of ≥32 weeks, fluorescein angiography performed, and with high oxygen exposure without adequate control were included.Results294 infants diagnosed with ROP were analyzed. Only 28 eyes from 14 patients with peripheral vascular abnormalities in older and heavier babies were included. Two distinct type of peripheral vascular changes were observed: group 1 or non-proliferative: areas of capillary non-perfusion along with widespread arteriovenous shunting between adjacent primary vessels, tortuosity of primary vessels, abnormal budding of tertiary vessels and capillaries, abnormal capillary tufts and absence of foveal avascular zone; group 2 or proliferative: all of the characteristics of group 1 plus leakage of dye from the boundary between perfused and non-perfused retina and/or optic disc.ConclusionPeripheral vascular abnormalities different from retinopathy of prematurity are observed in older than 32 weeks of gestational age, and heavier than 1500 g babies. This makes the authors classify these patients as having a disease caused solely by oxygen dysregulation at the neonatal intensive care unit similarly to the oxygen induced retinopathy in experimental studies.

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Section: Discussionmentioning

confidence: 69%

Vascular changes on fluorescein angiography of premature infants with low risk of retinopathy of prematurity after high oxygen exposure

et al. 2017

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“…FA has recently been implemented to evaluate retinal vascular morphology in eyes injected with intravitreal anti-vascular endothelial growth factor (VEGF) therapy 26–28 ; however, current studies on FA in ROP have been predominately descriptive, limiting their clinical impact and conclusions. 12, 14, 15, 26, 27, 29 As such, a gap exists in understanding the utility of FA on the accuracy of diagnosis and management of ROP by pediatric ophthalmologists and retina specialists. The purpose of this study was to evaluate the influence of FA on the diagnosis and management of ROP by ROP experts using wide-angle fundus images.…”

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confidence: 99%

Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity

et al. 2015

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Purpose To examine the influence of fluorescein angiography (FA) on the diagnosis and management of retinopathy of prematurity (ROP). Design Prospective cohort study. Participants Nine recognized ROP experts (3 pediatric ophthalmologists; 6 retina specialists) interpreted 32 sets (16 color fundus photographs; 16 color fundus photographs paired with the corresponding FAs) of wide-angle retinal images from infants with ROP. Methods All experts independently reviewed the 32 image sets on a secure web site and provided a diagnosis and management plan for the case presented, first based on color fundus photographs alone, and then by color fundus photographs and corresponding FA. Main Outcome Measures Sensitivity and specificity of the ROP diagnosis (zone, stage, plus disease, and category – i.e. no ROP, mild ROP, type-2 ROP, and treatment-requiring ROP) was calculated using a consensus reference standard diagnosis, determined from the diagnosis of the color fundus photographs by three experienced readers in combination with the clinical diagnosis based on ophthalmoscopic examination. The kappa statistic was used to analyze the average intergrader agreement among experts for the diagnosis of zone, stage, plus disease, and category. Results Addition of FA to color fundus photographs resulted in a significant improvement in sensitivity for diagnosis of stage 3 or worse disease (39.8% vs. 74.1%, P = 0.008), type-2 or worse ROP (69.4% vs. 86.8%, P = 0.013), and pre-plus or worse disease (50.5 vs. 62.6%, P = 0.031). There was a nonsignificant trend towards improved sensitivity for diagnosis of treatment-requiring ROP (22.2% vs. 40.3%, P = 0.063). Using the kappa statistic, addition of FA to color fundus photographs significantly improved intergrader agreement for diagnosis of treatment-requiring ROP. Addition of FA to color fundus photographs did not significantly affect intergrader agreement for the diagnosis of stage, zone, or plus disease. Conclusions Compared to color fundus photographs alone, fluorescein angiography may improve the sensitivity of diagnosis of ROP by experts, particularly for stage 3 disease. In addition, intergrader agreement for diagnosis of treatment-requiring ROP may improve with FA interpretation.

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“…Longitudinal measurements of intravitreal VEGF concentrations could help to answer this question, but might be difficult to perform in clinical practice. Persisting vascular abnormalities such as branching, shunting and capillary dropout have been described in fluorescein angiograms as late as 9 months after IVB 6 18…”

Section: Discussionmentioning

confidence: 99%

Treatment of type I ROP with intravitreal bevacizumab or laser photocoagulation according to retinal zone

et al. 2016

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Retinal fluorescein angiographic changes following intravitreal anti-VEGF therapy

Cited by 59 publications

References 11 publications

Vascular changes on fluorescein angiography of premature infants with low risk of retinopathy of prematurity after high oxygen exposure

Vascular changes on fluorescein angiography of premature infants with low risk of retinopathy of prematurity after high oxygen exposure

Influence of Fluorescein Angiography on the Diagnosis and Management of Retinopathy of Prematurity

Treatment of type I ROP with intravitreal bevacizumab or laser photocoagulation according to retinal zone

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