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Masahiko Sugimoto, Hisashi Matsubara, Ryohei Miyata, Yoshitsugu Matsui, Atsushi Ichio, Mineo Kondo; Usefulness of Ultra-Widefield Fluorescein Angiography by Oral Administration of Fluorescein. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5868.
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The Optos ultra-widefield (UWF) imaging system (Optos Panoramic 200MA™, Optos PLC. Dunfermline, Scotland, UK) can image 200° of the retina in one frame and also be used for fluorescein angiography (FA) with same wide angle. We present findings with UWF-FA using the Optos after an oral fluorescein administration to avoid various systemic and local complications with a conventional intravenous fluorescein injection.
Thirty four subjects (2 of normal volunteer, 17 of retinal vein occlusion, 11 of diabetic retinopathy, 2 of uveites and 2 of retina degeneration) were included after obtaining Institutional Review Board approval at Mie University Hospital (#2553). Two or three ampoules of fluorescein (approximately 20 mg/kg) were mixed with 30 ml of isotonic sports drink and orally administered. Fundus imaging was obtained using UWF imaging system and Oral-FA was performed (Oral UWF-FA) according to the same method as standard intravenous FA. The angiographic images of the fundus were taken at 5, 10, 15, and 20 minutes after oral administration.
The presence of fluorescein in the major retinal vessels was detected 5 minutes after oral administration, and the best images were obtained at 15 to 20 minutes. The peripheral vascular network was visible with good detail of the capillary architecture especially in the nasal and temporal quadrants. Only two patients had a mild skin rash, but all of other subjects did not have any serious systemic or local side effects.
Here we combined two methods as Oral UWF-FA. Our preliminary study suggests that Oral UWF-FA is feasible and can be used to assess vascular lesions of the peripheral retina with minimal complications.
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