Ultra-Widefield Fluorescein Angiographic Patterns, Retinal Microvascular Anomalies and Retinal Ischemic Index in Branch Retinal Vein Occlusions with Established Retinal Neovascularization

• Main Authors: Lip PL, Kolli H, Trivedi D
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-10-01
• Series: Clinical Ophthalmology
• Subjects: vitreous haemorrhage; ghost vessels; risk; laser
• Online Access: https://www.dovepress.com/ultra-widefield-fluorescein-angiographic-patterns-retinal-microvascula-peer-reviewed-article-OPTH

Peck Lin Lip, Hemalatha Kolli, Dipti Trivedi Birmingham and Midland Eye Centre, Birmingham, UKCorrespondence: Peck Lin LipBirmingham and Midland Eye Centre Sandwell & West Birmingham NHS Trust City Hospital, Dudley Road, Birmingham B18 7QH, UKTel [phone]Fax [phone]Email [e-mail]: To share the experience of using ultra-widefield fluorescein angiography (UWF-FA) in recognizing the potential signs for retinal neovascularizations (NVE) development in branch retinal vein occlusions (BRVO).Methods: Reporting angiographic findings in 60 BRVO eyes presenting with NVE and vitreous hemorrhage using UWF-FA investigation. Angiographic retinal ischemic index (ARI) was also calculated from UWF-FA as the ratio of digitally mapped ischemic retina area against area of optic disc, termed unit of disc diameter (DD).Results: We observed emerging angiographic features common to these patients: pattern of a localized non-perfused retina at early phase of UWF-FA remaining non-perfused at the late phase (black retinal ischemia, black-RI) (100%); presence of retinal microvascular anomalies (RMAs) at the “water-shed-border” of black-RI (100%); site of NVEs observed at either the same “water-shed-border” (42%) or from the main vessel branch within the black-RI (30%), or from both sites (28%); multiple NVEs were observed in all eyes except two with single active NVE. Median ARI size was 114 DD (SD 80 DD), range 5– 354 DD.Conclusion: We report a recurring angiographic pattern common to eyes with active BRVO-NVEs from UWF-FA, and NVEs in this clinical group can develop from varied ARI sizes. Further studies would be needed to establish the role of UWF-FA in predicting angiographic risk factors for BRVO-NVE.Keywords: definition, vitreous hemorrhage, ghost vessels, risk, laser