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Bhushan Ratansingh Wadekar, Rohan Chawla, Koushik Tripathy, Raj Pal, Yog Raj Sharma, Harsh Inder Singh, Babulal Kumawat, Ravi Bypareddy, Pradeep Venkatesh, Vitreo-Retina Services, DR R P Centre, All India Institute of Medical Sciences; Ultra-wide field fundus fluorescein angiography in rhegmatogenous retinal detachment. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):401.
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Ultra-wide field fundus (UWF) imaging allows assessment of 2000 fundus thereby facilitating analysis of peripheral retina. We sought to assess UWF fluorescein angiographic (UWFA) characteristics of rhegmatogenous retinal detachments (RRD), a predominantly peripheral retinal pathology.
We enrolled 30 consecutive eyes clinically diagnosed with RRD and studied their angiographic features using UWFA (200Tx™, Optos PLC, Dunfermline Scotland, United Kingdom).
The age range of patients was 8 to 64 years with 17 (56.67%) having RRD duration of less than 8 days and 13 (43.33%) with history of more than 8 days. 14 (46.67 %) patients had previous history cataract surgery, 6 (20%) were myopes, 2 (6.67%) had giant retinal tears, 3 (10%) were post-traumatic, 2 (6.67%) had iridofundal coloboma and remaining 3 (10%) had miscellaneous associations. Salient angiographic findings included paravascular changes such as venous dilatation (100%), paravascular leak (100%), peripheral capillary non-perfusion (CNP) (100%), vascular tortuosity (73%), minimal disc leak (46.67%) and neovascularisation elsewhere (26.7%). The edge of break could be identified by multiple small hyperfluorescent knob-like points along it (“street-lamps along a city-road appearance”). Additionally sub-retinal proliferative vitreo-retinopathy (PVR) changes (23.33%) were noted as blocked patterns of hypo-fluorescence.
UWF technology efficiently images peripheral retina. Angiographic features such as venous dilatation, paravascular leak, peripheral CNP are seen in almost all RRD cases. Vascular tortuosity, neovascularisation, minimal disc leak, patterned break and sub-retinal PVR, though relatively inconsistent are other associated important features of RRD. These features help in understanding the pathophysiology of detached retina and would provide valuable inputs while analyzing and managing exudative retinal detachments.
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