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Michael Klufas, Nicolas A Yannuzzi, Claudine E Pang, Sowmya Srinivas, Srinivas R Sadda, K Bailey Freund, Szilard Kiss; Feasibility and Clinical Utility of Ultra-Widefield Indocyanine Green Angiography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):208. doi: https://doi.org/.
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To evaluate the feasibility and clinical utility of a novel non-contact scanning laser ophthalmoscope (SLO) based ultra-widefield indocyanine green (UWF-ICGA) angiographic system.
A retrospective review between 2009-2013 of consecutive patients that underwent imaging using a modified Optos® P200Tx (Optos PLC., Dunfermline, Scotland, UK) that produced high resolution images of the choroidal vasculature with up to a 200-degree field. UWF-ICGA was performed for a variety of conditions in order to assess utility for diagnostic purposes and treatment monitoring. Three experienced trained readers (SK, KBF, SRS) independently analyzed each UWF-ICGA image for the presence of retinal pathology.
UWF-ICGA was performed on 138 eyes of 69 patients (30 males, 39 females). Mean age was 58 ± 16.9 years (range 24-85). High-resolution images of the choroidal circulation were obtained out to 200-degrees of the fundus in all eyes. The most common ocular pathologies imaged included central serous chorioretinopathy (CSCR, 24 patients), uveitis (16 patients) and age-related macular degeneration (AMD, 12 patients). A review of images revealed peripheral changes (outside the 50-60 degree view of standard ICGA imaging systems) on UWF-ICGA in 67.4% of eyes. Peripheral angiographic findings varied by condition and included dilated vessels, hyperfluorescence including choroidal neovascularization (CNV) with leakage, and hypofluorescence including vessel luminal filling defects.
The use of ultra-widefield imaging of the ocular fundus is rapidly expanding with significant implications for the diagnosis and treatment of vitreoretinal disorders. In our series of 138 eyes, SLO based UWF-ICGA was clinically practical and provided detailed images of both the central and peripheral choroidal circulation.
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