The utility of ultra-widefield fluorescein angiography in pediatric retinal diseases

Calvo, Charles M.; Hartnett, M. Elizabeth

doi:10.1186/s40942-018-0122-2

Cited by 24 publications

(16 citation statements)

References 33 publications

(36 reference statements)

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“…This limitation was partially resolved using real time video recordings of the images obtained by the binocular ophthalmoscope. Examination instruments such as RetCam R , retinoscopy, or wide-field angiography have allowed repeated examination and analysis of retinal images in numerous studies (41)(42)(43)(44). However, these techniques are rarely available in hospitals, so the indirect binocular ophthalmoscope continues to be used by numerous specialists.…”

Section: Discussionmentioning

confidence: 99%

Risk Calculator for Retinopathy of Prematurity Requiring Treatment

et al. 2020

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Importance: Vascular delay that occurs early in the development of retinopathy of prematurity (ROP) is a risk factor that can be compensated by ensuring a good rate of retinal vascularization to avoid ROP that requires treatment. Background: The objective of the present study was to determine the association between ROP that requires treatment and risk factors such as the extent of the temporal avascular area of the retina and the number of days of mechanical ventilation (MV). Design: Observational retrospective case-control study. Participants: Two hundred and twenty-eight premature newborns included in the screening protocol for retinopathy of prematurity. Methods: Subjects underwent retinal examination in the 4 and 6th postnatal weeks. Main Outcome Measures : The temporal avascular area was measured in disc diameters (DD), while the MV time was measured in days of treatment. Results: Patients with a longer MV time had a higher risk of treatment (R 2 : 24.7, p < 0.0001; increase in risk of 8.1% for each additional day), as did those who showed greater avascular area (R 2 : 24.7, p < 0.0001; increase in risk of 111% for each additional DD). An online calculator system and a table are presented for calculating the risk of ROP requiring treatment as a function of these two risk factors. Conclusions and Relevance: The temporal avascular area of the retina and MV time must be taken into account in the first examination of the newborn to predict the need for ROP treatment.

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Section: Discussionmentioning

confidence: 99%

Risk Calculator for Retinopathy of Prematurity Requiring Treatment

et al. 2020

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“…Medical fluorescein is used extensively in clinical practice, most commonly in ophthalmic angiography (21,22). It has been shown to be safe for human inhalation in diagnostic tests (23).…”

Section: (Ii)mentioning

confidence: 99%

Aerosolised fluorescein can quantify FFP mask faceseal leakage: a cost-effective adaptation to the existing point of care fit-test.

Zaman

Seligman

Lloyd

et al. 2020

Preprint

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Background Filtering facepiece (FFP) respirators must provide an adequate faceseal to protect healthcare workers from harmful particles. A qualitative fit-test using bitter-tasting aerosols the commonest way to determine if an FFP mask is safe enough for clinical use. This taste-test is subjective and can be biased by placebo. We propose a cheap and quantitative modification of the taste-test, by measuring the amount of fluorescein staining filter paper behind the FFP mask after a fit-test protocol, using digital image analysis. Methods Medical grade fluorescein was added to bitter-tasting denatonium benzoate solution and Aerosolised during a mask fit-testing protocol. Scientific filter paper was placed on the inner surface of the mask. Participants were asked if they could taste the solution to determine their qualitative ‘pass’ or ‘fail’ result. Filter paper photographs were analysed after the test to quantify total fluorescence (TF). TF levels in the taste-test ‘pass’ and ‘fail’ groups were compared.Results Fifty-six healthcare professionals completed the fluorescein mask fit-test protocol. 32 (57%) ‘passed’ the qualitative (taste) test and the remainder ‘failed’. There was a significant difference in TF between the groups based on their qualitative results (p <0.001). A cut-off of TF = 5.0 x 106 fluorescence units was determined by analysing the precision (78%) and recall (84%) of the fluorescein test. Applying this cut-off resulted in 5 out of 56 participants (9%) being reclassified from ‘pass’ to ‘fail’ by the fluorescein test. 7 out of 56 (12%) participants were reclassified from ‘fail’ to ‘pass’.Conclusions Fluorescein is detectable and sensitive to identify faceseal leaks in FFP masks. The fluorescein fit-test is discriminating in its ability to divide people into ‘pass’ and ‘fail’ groups similarly to the taste-test. The adaptations are low-cost and could be incorporated in the point-of-care setting. After further validation the fluorescein test could increase safety for staff by reducing the number of false ‘pass’ by the taste-test. It could also reassure people who have ‘failed’ the taste-test that they have low levels of fluorescein leak, enabling them to return to clinical practice safely.

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“…1 UWF has allowed to expand the field of view of imaging from 30 to 60 to up to 200 in a single image, capturing more of the periphery at retina. 2 Most pediatric retinal diseases manifest in peripheral retina and UWF angiography has proved to be extremely useful to diagnose the proliferative and exudative changes. Although most cases still require general anesthesia or light sedation, UWF fundus photography and angiography can be done as an outpatient procedure without the need for anesthesia, using "flying-baby" technique to position the child primarily for retinopathy of prematurity screening.…”

Section: Funduscopic Photography and Fluorescein Angioretinography Inmentioning

confidence: 99%

“…Although most cases still require general anesthesia or light sedation, UWF fundus photography and angiography can be done as an outpatient procedure without the need for anesthesia, using "flying-baby" technique to position the child primarily for retinopathy of prematurity screening. 2 Confocal scanning laser ophthalmoscopy, allows for elimination of artefact reflections. Portable wide-angle cameras are now available for fundus photography, which allow direct visualization and capture in pediatric patients unable to position themselves.…”

Section: Funduscopic Photography and Fluorescein Angioretinography Inmentioning

confidence: 99%

“…3 Fundus imaging now plays an important role in retinopathy of prematurity, familial exudative vitreoretinopathy, Coats disease, Incontentia pigmenti, X-linked retinoschisis, Stargardt disease, Best disease, toxoplasmosis chorioretinitis, juvenile sarcoidosis, choroidal melanoma, juvenile idiopathic arthritis, pars planitis, and traumatic retinal detachment. 2 Recent imaging tools have not only allowed improved diagnosis, screening, documentation, monitoring, and image-guided treatment of these diseases. They have also widened the scope of research.…”

Section: Funduscopic Photography and Fluorescein Angioretinography Inmentioning

confidence: 99%

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