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Kathleen Farhang, Kimberly Baynes, Francesco Pichi, Careen Y Lowder, Sunil K Srivastava; Diagnostic findings identified by ultra-widefield fluorescein angiography in uveitis patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):261.
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Ultra-widefield fluorescein angiography (UWFFA) is an emerging technology that allows for improved visualization of the retinal periphery. The additional information offered by retinal periphery visualization may alter diagnosis, management, and treatment of many retinal conditions. We aimed to identify changes seen using UWFFA in patients with uveitis and ocular inflammatory diseases.
An IRB approved retrospective, observational consecutive case series of ophthalmic patients with uveitis at the Cleveland Clinic Foundation Cole Eye Institute was performed. All patients underwent comprehensive ophthalmic exam and UWFFA with the Optos 200Tx system. High magnification views were compared to the ultra-widefield FA to simulate standard 50-degree fundus images. Any findings outside the range of a standard fluorescein angiogram were documented.
116 patients with uveitis that required fluorescein angiography were included in the study. A total of 231 visits resulted in 458 sets of ultra-widefield FA images. Of the study population, 63.8% were female. The most common diagnoses included sarcoidosis, retinal vasculitis, idiopathic panuveitis, birdshot retinopathy, and intermediate uveitis. 71.2% of ultra-widefield images yielded information that would not have been found with standard imaging technology. Retinal findings outside the standard FA view included: peripheral non-perfusion (23.1%), focal vessel leakage (41.9%), diffuse leakage (70.9%), chorioretinal scars (19.7%), and multifocal lesions (7.7%).
Standard 50-degree fundus photography may not detect clinically important abnormalities that may be more easily and accurately documented with UWFFA. In the management of certain subtypes of uveitis including retinal vasculitis, intermediate uveitis and ocular sarcoidosis, imaging of the retinal periphery with the Optos 200Tx system has added value over standard fundus photography.
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