Observation of the far peripheral retina of normal eyes by ultra-wide field fluorescein angiography

Abstract

Purpose The appearance of the far peripheral retina in normal eyes was observed using an Optos ultra-wide field fluorescein angiography imaging system. Methods A cross-sectional study of ultra-wide field pseudocolor and angiography images obtained using the Optos 200Tx. Four different non-vascular and six vascular-associated fluorescence features in far peripheral retina were analyzed. Results A total of 166 eyes in 83 patients met the inclusion criteria. The mean patient age was 40.78 ± 10.94 years (range: 20–65 years) with a female-to-male ratio of 0.98. Slight cataract were present in 64 eyes (38.55%), low to moderate myopia in 50 eyes (30.12%), and unspecified visual disturbances in 52 eyes (31.33%). Far peripheral retinas were found to have mottled florescent band in 42.17% eyes, ground glass hyperfluorescence in 84.34% eyes, granular hyperfluorescence in 12.65% eyes, local mottled fluorescence in 10.84% eyes, vascular anastomosis with a peripheral avascular area in 36.23% eyes, invisible capillary details in 50.67% eyes, vessels passing through the ora serrata in 16.98% eyes, late-phase slight leakage in 32.53% eyes, angiectasis in 18.67% eyes, and microaneurysm in 34.94% eyes. Conclusion Ultra-wide field fluorescein angiography revealed various fluorescence features in the periphery of normal eyes, providing a basis for interpreting normal and pathological changes in peripheral retina and an important reference for clinical work.

Peripheral Retinal Leakage after Intravenous Administration of a Gadolinium-based Contrast Agent: Age Dependence, Temporal and Inferior Predominance and Potential Implications for Eye Homeostasis

“… 1 Another study reported the appearance of a mottled fluorescent band in the far peripheral retina in 42.17%, ground glass hyper fluorescence in 85.34%, and late-phase slight leakage in 32.53% of normal eyes. 2 The mottled fluorescent band can occur with vascular leakage simultaneously or separately. 1 The molecular weight of fluorescein is 389.38 g/mol.…”

“…1), was a recently reported finding observed occasionally in normal eyes on ultra-widefield fluorescein angiography (UWFA). 1,2 Since the contrast medium leaks at the far peripheral part of the retina, it is difficult to observe in a regular fundus examination. Therefore, the effect of aging on PRL and the relationship between PRL and various diseases are not well understood.…”

“…1 ), was a recently reported finding observed occasionally in normal eyes on ultra-widefield fluorescein angiography (UWFA). 1 , 2 …”

Peripheral Leakage on Ultra-Widefield Fluorescein Angiography in Patients With Inherited Retinal Degeneration

“…Those studies ranged in their commentary on retinal leakage, with some that did not appear to observe any leakage, and others that identified leakage in up to 46.9% of patients. 20 -25 The studies that did find leakage did not describe the extent of the leakage in a systemic fashion as we did, or they discovered only very mild cases. 21 -23 The cases of far peripheral leakage shown in our patients appeared more extensive than most current descriptions in “normal” eyes, and instances of midperipheral or posterior pole leakage as seen in some of our cases were not described in case series of “normal” eyes.…”

“…We were able, however, to compare our findings to previously published studies of ultra-widefield FA findings in "normal" eyes. [20][21][22][23][24][25] We note that none of those studies imaged patients without a clinical indication, which is why we placed the word normal in quotation marks. Those studies ranged in their commentary on retinal leakage, with some that did not appear to observe any leakage, and others that identified leakage in up to 46.9% of patients.…”