Purchase this article with an account.
Andrew Schneier, David Kim, Deborah VanderVeen, Shizuo Mukai; Ultra-Widefield Fluorescein Angiography in Children Using Oral Fluorescein Administration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):18.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Oral administration of fluorescein sodium is a safe alternative to intravenous administration and may be indicated in pediatric patients deemed unsuitable for venipuncture. Early results with oral fluorescein angiography (OFA) using conventional fundus photography systems were disappointing due to lack of contrast and resolution in the images produced. The scanning laser ophthalmoscope (SLO) mitigates factors which degrade image quality in OFA. We present a case series of nine children who underwent ultra-widefield SLO OFA.
Institutional Review Board approval was obtained. Nine patients (6 girls, 3 boys) ranging in age from 4 to 14 years were imaged with the Optos system (Optos PLC, Dunfermline, UK). Indications for imaging were proliferative retinopathy in 3 cases (FEVR, Sickle Retinopathy), and screening for and surveillance of other retinal vascular anomalies in 6 cases (VHL, Choroidal Hemanigioma, Coats’ Disease). Five to 10 ml of 10% fluorescein sodium mixed in juice were administered orally. Photography commenced when contrast was first observed in the retinal vasculature.
OFA with the Optos system yielded excellent diagnostic information in all cases (Figs. 1-2). No adverse event was observed. The patients reported less discomfort with the test compared to those done on standard non-SLO systems.
Ultra-widefield SLO OFA captures up to 200 degrees of peripheral retina (vs. 30-60 degrees in standard angiography) permitting simultaneous analysis of distant retinal regions in a single image. Optos OFA images of the macula and peripheral retina are of high enough resolution and contrast to provide diagnostic value in children with retinal diseases. This technique may be safely and more comfortably employed by clinicians managing pediatric patients with retinal vascular disorders.
This PDF is available to Subscribers Only