Peripheral Vessel Leakage (PVL): A New Angiographic Finding in Diabetic Retinopathy Identified with Ultra Wide-Field Fluorescein Angiography

Oliver, Scott C. N.; Schwartz, Steven D.

doi:10.3109/08820538.2010.481239

Cited by 86 publications

(54 citation statements)

References 26 publications

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“…selected 1 or more images from each angiogram series during the arteriovenous phase (between 45 seconds and 2 minutes) and graded all 148 angiograms for the presence or absence of retinal nonperfusion of > _1 disc area, neovascularization (defined as focal leakage > _2 disc diameters), focal macular edema (defined as late hyperfluorescence > _500 mm diameter covering less than 75% of the macula), and diffuse macular edema (defined as late hyperfluorescence covering > _75% of the macula). 10,13 The best image was chosen based on the largest field of view and the greatest image clarity. Figure 1 illustrates typical findings encountered when grading.…”

Section: Methodsmentioning

confidence: 99%

Characterization of Ischemic Index Using Ultra-widefield Fluorescein Angiography in Patients With Focal and Diffuse Recalcitrant Diabetic Macular Edema

Patel¹,

Messner²,

Teitelbaum³

et al. 2013

American Journal of Ophthalmology

112

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Section: Methodsmentioning

confidence: 99%

Characterization of Ischemic Index Using Ultra-widefield Fluorescein Angiography in Patients With Focal and Diffuse Recalcitrant Diabetic Macular Edema

Patel¹,

Messner²,

Teitelbaum³

et al. 2013

American Journal of Ophthalmology

112

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“…In addition, the seven-standard fields would have missed pathology shown on UWF FA images in 10% of eyes [30]. Other studies have demonstrated the association between peripheral retinal nonperfusion and the occurrence of neovascularization, macular ischemia, and diabetic mac-http://dx.doi.org/10.21561/jor.2016.1.1.1 ular edema (DME) [20,[31][32][33]. Another study suggested that UWF FA will be used to guide the management of DR [34].…”

Section: Clinical Applications Of Ultra-widefield Imaging Diabetic Rementioning

confidence: 99%

“…Ultra-widefield FA is available in the Optos system since the P200A model provides a high-resolution wide-angle angiographic module. Single capture using a 488-nm laser with a 500-nm barrier filter enables angiographic view of peripheral vascular structure, including perfusion status, leakage, and staining, which can be missed on the seven-standard fields of the Early Treatment Diabetic Retinopathy Study [17][18][19][20]. ICGA was recently added to the multimodal capabilities of the Optos.…”

Section: Ultra-widefield Imaging Modalitiesmentioning

confidence: 99%

Ultra-Widefield Retina Imaging: Principles of Technology and Clinical Applications

Lee

Sagong

2016

J Retin

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The peripheral retina is frequently affected by various diseases and ultra-widefield (UWF) imaging has become an essential tool for evaluation of peripheral retinal pathology. The wide angle and high resolution of this imaging device were recently updated along with multimodal capabilities, including pseudocolor fundus photographs, fluorescein and indocyanine green angiography, and autofluorescence images. Using this UWF technology, important clinical observations have been made in the normal population and patients with certain diseases including diabetic retinopathy, retinal vascular occlusion, retinal detachment, uveitis, age-related macular degeneration, and choroidal tumors. Although peripheral distortion and the need for clinical validation are obstacles to overcome for the accurate quantification and more generalized use, UWF imaging has provided new insights into a variety of disorders and has become the standard-ofcare imaging modality for many diseases. Therefore, use of UWF retinal imaging for the daily retina practice in the near future is inevitable. This review will describe the principles of UWF technologies with several modalities, and include its clinical applications and then suggest future directions.

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“…12 The degree of peripheral nonperfusion has also been linked to increased diabetic macular edema (DME) in treatment-naïve patients with diabetic retinopathy, 13 as well as more recalcitrant DME, as evidenced by a greater number of macular photocoagulation treatments and less reduction in central macular thickness on optical coherence tomography (OCT). 14 …”

Section: Diabetic Retinopathymentioning

confidence: 99%

Wide-field Imaging of Retinal Diseases

Kim¹,

Moshfeghi²

2015

US Ophthalmic Review

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125Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. Since the invention of the direct ophthalmoscope by Hermann von Helmholtz in 1851, techniques to visualize the fundus have grown exponentially both in number and sophistication. Notably, wide-field retinal imaging has taken center stage over the past 2 decades. Given its increasing popularity in research and clinical use, it is important to be aware of the different types of wide-field imaging currently available, as well as the clinical applications for, advantages, and limitations of widefield retinal imaging. This review article aims to highlight our current understanding of wide-field retinal imaging and provide an outlook for its future implications. Historical PerspectiveThe first fundus camera was developed by Frederick Dimmer at the turn of the 20th century. Dimmer was the first to incorporate fundus photography into an ophthalmic textbook, and he published the first photographic atlas in black-and-white. AbstractRetinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications. KeywordsWide-field imaging, ultra-wide-field imaging, retinal imaging, Optos, Heidelberg, fluorescein angiography, autofluorescence, diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity Disclosure: Esther Kim, MD, has no relevant conflicts of interest to declare. Andrew A Moshfeghi, MD, MBA, has been a consultant

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Peripheral Vessel Leakage (PVL): A New Angiographic Finding in Diabetic Retinopathy Identified with Ultra Wide-Field Fluorescein Angiography

Abstract: Untreated peripheral non-perfusion and late peripheral vascular leakage detected using ultra wide-field FA are associated with neovascularization in diabetic retinopathy. PVL may be associated with focal diabetic macular leakage in this cohort.

Cited by 86 publications

References 26 publications

Characterization of Ischemic Index Using Ultra-widefield Fluorescein Angiography in Patients With Focal and Diffuse Recalcitrant Diabetic Macular Edema

Characterization of Ischemic Index Using Ultra-widefield Fluorescein Angiography in Patients With Focal and Diffuse Recalcitrant Diabetic Macular Edema

Ultra-Widefield Retina Imaging: Principles of Technology and Clinical Applications

Wide-field Imaging of Retinal Diseases

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