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F. Viola, G. Staurenghi, I. Musicco, C. Veronese, P. Danzi, M. Mainster; Wide Field Dynamic Angiography in Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2999.
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Purpose: To study the retinal and choroidal characteristics of rhegmatogenous retinal detachments before and after surgery using a scanning laser ophthalmoscope (SLO), a wide field contact ophthalmoscopic lens, and simultaneous fluorescein angiography (d-FA) and dynamic indocyanine green angiography (d-ICGA). Methods: We studied 20 consecutive patients with partial retinal detachments. Sixteen patients were male and four were female. Their mean age was 40 year old (24-65). d-FA and d-ICGA were performed using a confocal SLO (HRA, Heidelberg Engineering GmbH, Dossenheim, Germany) and a contact wide field lens (Staurenghi 230 SLO lens, Ocular Instruments, Inc., Bellevue WA, USA). Each patient received an intravenous injection of 5 ml of 20% sodium fluorescein solution and 2 ml of 10% indocyanine green solution. Two observers evaluated all d-ICGA choroidal flow studies. Results: The equatorial area of the retina was well-visualized in every angiogram. Detached retina masked choroidal vessels in d-ICGA. d-FA documented sluggish circulation, capillary dilation and fluorescein leakage in areas of detached retina. Peripheral regions of detached retina were not perfused. Retinal holes were identified with red-free imaging, infrared, d-FA and d-ICGA in 65%, 40%, 25% and 3% of patients, respectively RPE degeneration was present and choroidal and retinal perfusion were diminished or absent in areas that had undergone diathermy or cryotherapy during retinal detachment surgery. Capillary dilation diminished post-operatively in reattached retina. Choroidal circulation remained normal in undetached areas three months after scleral buckling surgery for retinal detachment. Conclusions: Contact-lens, SLO angiography provides wide field images that are useful for evaluating and documenting retinal findings in patients before and after surgery for rhegmatogenous retinal detachment. Retinal perfusion is decreased in detached retina. Choroidal blood flow is not affected by scleral buckling surgery, at least in retinal regions that were attached pre-operatively.
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