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P. Danzi, F. Morescalchi, F. Gandolfo, E. Gandolfo, G. Staurenghi; Hemodynamics Changes After Surgery for Rhegmatogenous Retinal Detachment Studied With the Scanning Laser Ophthalmoscopy and Angiography With a Wide Field Contact Lens System . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4667.
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to evaluate the peripheral chorioretinal circulation before and after surgery for rhegmatogenous retinal detachment by mean of a contact lens system (the Ocular Staurenghi 230 SLO Retina Lens) that provides a 5–fold increase in the field of view of a confocal scanning laser ophthalmoscope (SLO).
twenty patients with rhegmatogenous retinal detachment were examined in a prospective study on the hemodynamics of the choroidal and retinal circulation following surgical treatment of the disease. Simultaneous dinamic fluorescein and indocyanine green angiography was performed, before and after surgery, with an integrated wide–field contact lens system allowing a 150 degree imaging field examination with SLO.
retinal and choroidal abnormalities affecting the peripheral retina were detected. Capillary non perfusion, artero–venous shunt, vascular leakage were common anomalies before surgey that were correlated with the duration and height of detachment, but not with its extent. The recovery in the normal circulation was most remarkable after vitrectomy than after circonferential buckling in association with scleral buckling and cryopexy. In some cases an abnormal vascular leakage before and after surgery was correlated with late onset of PVR or epiretinal membranes. Angiographically apparent choroidal vascular changes overlied the scleral exoplant and the encircling buckling only if cryopexy or laser treatment were associated. Vortex vein occlusion developed in more than 50% of cases and newly formed drainage routes compensated for venous congestion.
a confocal SLO has adequate resolution for clinically useful angiographic imaging using a wide field contact lens system. Dynamic and static wide–field angiography can be performed without the limitations of manual or computer–automated photomontages. Peripheral retinal conditions and remodeling of choroidal venous drainage can be easily studied and recorded. The blood–retinal barrier breakdown extent and the efficacy of choroidal plasticity to compensate the choroidal venous congestion are prognostic factor for predicting the visual and anatomical outcome after surgery for rhegmatogenous retinal detachment.
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