Ultra-widefield fundus fluorescein angiography in pediatric retinal vascular diseases

Temkar, Shreyas; Azad, Shorya Vardhan; Chawla, Rohan; Damodaran, Sourav; Garg, Gaurav; Regani, Harika; Nawazish, Shaikh; Raj, Nimmy; Venkatraman, Vatsalya

doi:10.4103/ijo.ijo_1688_18

Cited by 25 publications

(15 citation statements)

References 20 publications

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“…If the far periphery of the retina is not examined, the presence of macular edema might be attributed to a different clinical entity, such as Irving–Gass syndrome, pars planitis, diabetic retinopathy, retinal vein occlusion, or another condition (patient 3 is an example of this). The diagnostics of peripheral retinal telangiectasia are definitely easier with the use of ultra–wide-field (UWF) FA systems, which provide an easy view of the periphery of the retina [ 36 , 37 , 38 , 39 , 40 ]. Cases with the lesions located in the far periphery might be easily missed if only standard seven field imaging is used.…”

Section: Discussionmentioning

confidence: 99%

“…Cases with the lesions located in the far periphery might be easily missed if only standard seven field imaging is used. UWF images can also guide treatment, as the areas of abnormal vasculature and non-perfusion are visualized more precisely [39,40]. Thus, LPC or cryotherapy in IPT cases diagnosed with UWF-FA systems are potentially more effective, as all the abnormal areas of the retina are treated.…”

Section: Diagnosticsmentioning

confidence: 99%

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Idiopathic Peripheral Retinal Telangiectasia in Adults: A Case Series and Literature Review

Gawęcki¹

2021

JCM

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Idiopathic peripheral retinal telangiectasia (IPT), often termed as Coats disease, can present in a milder form with the onset in adulthood. The goal of this case series study and literature review was to describe and classify different presenting forms and treatment of this entity and to review contemporary methods of its management. Six cases of adult onset IPT were described with the following phenotypes based on fundus ophthalmoscopy, fluorescein angiography, and optical coherence tomography findings: IPT without exudates or foveal involvement, IPT with peripheral exudates without foveal involvement, IPT with peripheral exudates and cystoid macular edema, and IPT with peripheral and macular hard exudates. Treatments applied in this series included observation, laser photocoagulation, and anti-vascular endothelial growth factor (VEGF) treatment with variable outcomes depending upon the extent of IPT, the aggressiveness of laser treatment, and the stringency of follow-up. The accompanying literature review suggests that ablative therapies, especially laser photocoagulation, remain the most effective treatment option in adult-onset IPT, with anti-VEGF therapy serving as an adjuvant procedure. Close follow-up is necessary to achieve and maintain reasonable good visual and morphological results.

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Section: Discussionmentioning

confidence: 99%

Section: Diagnosticsmentioning

confidence: 99%

Idiopathic Peripheral Retinal Telangiectasia in Adults: A Case Series and Literature Review

Gawęcki¹

2021

JCM

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“…With the advent of wide-field portable RetCam III imaging, intraoperative FA can be obtained and thus facilitates full identification of abnormal retinovascular areas, where treatment such as laser or cryotherapy could be administrated under general anesthesia for pediatric patients (12)(13)(14)(15). The purpose of the study was to investigate the clinical and treatment features of Coats' disease with retinal cyst compared with that without retinal cyst in pediatric patients underwent RetCam III wideangle FA guided treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Pediatric Coats' Disease With Retinal Cyst Using Wide-Angle Fluorescein Angiography

Liu

Deng

et al. 2021

Front. Med.

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Purpose: To assess the demographic and treatment features of pediatric patients of Coats' disease with retinal cyst using wide-angle FA.Design: A retrospective, hospital based, cross-sectional study.Participants: Pediatric patients of Coats' disease underwent wide-angle FA.Methods: A retrospective review of pediatric patients of Coats' disease who underwent wide-angle FA at a single center from January 2015 to July 2020. Demographic and treatment features were compared between patients with or without retinal cyst.Main Outcome Measures: Demographic and treatment outcomes.Results: There were 123 pediatric Coats' patients in our study, and 18.70% (23/123) of the patients developed complications with retinal cyst, 73.9% (17/23) of the retinal cysts were located in the inferior-temporal quadrant and 82.6% (19/23) of the retinal cysts were located in the peripheral retina anterior to the vortex veins. Compared with patients without retinal cyst, patients with retinal cyst had more clock-hours of telangiectasia on FA (7.32 vs. 5.41, p = 0.031), and may need more total treatments (7.47 vs. 3.53, p = 0.023) including laser photocoagulation (4.08 vs. 2.31, p = 0.019) or intravitreal anti-VEGF (3.13 vs. 2.23, p = 0.039), and also required a longer time for telangiectasia resolution (22.33 vs. 18.53 months, p = 0.043).Conclusion: Pediatric patients with Coats' disease complicated by retinal cyst presented with more clock-hours of telangiectasia on FA and needed more total treatments and longer time for telangiectasia resolution.

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“…Indications : FFA has been studied extensively in ROP. [ 57 58 59 ] It helps clearly demarcate the vascular from avascular retina, identify flat neovascularization not easily discernible to the naked eye, and monitors treatment response [Fig. 5a and b ].…”

Section: Fundus Fluorescein Angiographymentioning

confidence: 99%

Imaging the pediatric retina

Agarwal¹,

Vinekar

Chandra

et al. 2021

Indian Journal of Ophthalmology

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Recent decade has seen a shift in the causes of childhood blinding diseases from anterior segment to retinal disease in both developed and developing countries. The common retinal disorders are retinopathy of prematurity and vitreoretinal infections in neonates, congenital anomalies in infants, and vascular retinopathies including type 1 diabetes, tumors, and inherited retinal diseases in children (up to 12 years). Retinal imaging helps in diagnosis, management, follow up and prognostication in all these disorders. These imaging modalities include fundus photography, fluorescein angiography, ultrasonography, retinal vascular and structural studies, and electrodiagnosis. Over the decades there has been tremendous advances both in design (compact, multifunctional, tele-consult capable) and technology (wide- and ultra-wide field and noninvasive retinal angiography). These new advances have application in most of the pediatric retinal diseases though at most times the designs of new devices have remained confined to use in adults. Poor patient cooperation and insufficient attention span in children demand careful crafting of the devices. The newer attempts of hand-held retinal diagnostic devices are welcome additions in this direction. While much has been done, there is still much to do in the coming years. One of the compelling and immediate needs is the pediatric version of optical coherence tomography angiography. These needs and demands would increase many folds in future. A sound policy could be the simultaneous development of adult and pediatric version of all ophthalmic diagnostic devices, coupled with capacity building of trained medical personnel.

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Ultra-widefield fundus fluorescein angiography in pediatric retinal vascular diseases

Cited by 25 publications

References 20 publications

Idiopathic Peripheral Retinal Telangiectasia in Adults: A Case Series and Literature Review

Idiopathic Peripheral Retinal Telangiectasia in Adults: A Case Series and Literature Review

Clinical Characteristics of Pediatric Coats' Disease With Retinal Cyst Using Wide-Angle Fluorescein Angiography

Imaging the pediatric retina

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