Abstract
Purpose: :
To determine the relationship between macular edema and peripheral vascular leakage in the mid-peripheral and far peripheral retina using ultra-wide field fluorescein angiography.
Methods: :
An Optos P200 Scanning Laser Ophthalmoscope was used to obtain 200-degree fluorescein angiograms (FA) of the fundus in consecutive patients seen at the Retina Center in the New York Eye and Ear Infirmary. The ultra-wide field FAs and macular optical coherence tomography (OCTs) of 156 eyes in 99 patients with macular leakage were analyzed.
Results: :
The most common past ocular histories for patients with cystoid macular edema (CME) were proliferative diabetic retinopathy (67%), central and branch retinal vein occlusion (18%), and exudative age-related macular degeneration (13%). The majority of eyes with macular leakage on FA and CME confirmed on OCT had fluorescein leakage in the mid-periphery (97%) and far periphery (90%) of the retina. Thirty-six eyes (23%) had greater leakage in the far periphery than in the central or mid-periphery, and two percent with CME and far peripheral leakage had no leakage in the posterior fundus. Fifty-six patients (56%) had bilateral leakage in the macula.
Conclusions: :
Macular edema is strongly associated with peripheral vascular leakage. In severe cases, the far peripheral retina and the contralateral eye should be thoroughly examined. Ultra- wide field angiograms are useful for detecting far peripheral leakage and may provide an earlier indication of the need for anti-vascular endothelial growth factor injections or pan-retinal photocoagulation.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina • imaging/image analysis: clinical