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Michael D. Bennett, Karl E. Waite; Quantitative Analysis Of Macular Perfusion And/or Ischemia In Patients With Macular Edema Using Ultra-wide Field Fluorescein Angiography. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1722.
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To assess and quantify the fluorescein angiographic macular findings of patients with macular edema pre and one month post Anti-VEGF injection, and to determine if this new concept for fluorescein angiography could correlate with OCT.
A novel, prospective Quantative Analysis was performed on the ultra-widefield fluorescein angiograms (Optos plc.) of 20 subjects with macular edema associated with AMD, DR & RVO at baseline and one month post intra-vitreal injection of Anti-VEGF. The maximum luminosity achieved by 1st order vessels in the transit phase was used to normalize luminance values obtained throughout the fluorescein angiogram within a grid centered on the fovea and extending to a diameter of 6mm. Analysis was performed to determine if gamma normalization and luminance analysis in the macular region correlated with OCT thickness.
A value based on luminance was determined for each pixel in the macular grid, allowing color maps to be created. From the pre and post anti-VEGF fluorescein angiograms it was possible to develop luminance difference maps which were compared to OCT (Heidelberg Engineering) on the same patients.
Assessing perfusion and/or ischemia in the macula by quantification of normalised luminance appears to be a valuable clinical adjunct in determining the efficacy of anti-VEGF therapy in patients with macular edema.
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