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Hanna Kim, Valentina Franco-Cardenas, Carolyn Pan, Gad Heilweil, Irena Tsui, Jean-Pierre Hubschman, Steven D. Schwartz; Ultra Wide-Field Angiographic Characteristics of Fellow Eyes in Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2665.
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© ARVO (1962-2015); The Authors (2016-present)
To study angiographic features present in fellow eyes of patients with branch retinal vein occlusions (BRVO) using ultra wide-field fluorescein angiography.
An imaging database of ultra wide-field fluorescein angiograms performed at a single academic institution was searched for patients with a primary diagnosis of BRVO. Patients with the diagnosis of diabetes mellitus were excluded. Images were graded for the presence of macular edema, peripheral ischemia, and neovascularization in affected eyes. Given the strong association between systemic hypertension and vein occlusions, images of fellow eyes were graded for the following hypertensive-related retinal vascular changes: arteriovenous nicking, vessel tortuosity, microaneurysms, other vascular anomalies, and prior occlusive events.
A total of 80 eyes of 40 patients with a diagnosis of BRVO were analyzed. Angiographic macular edema (92.5%), peripheral ischemia (62.5%), and neovascularization (27.5%) were observed in affected eyes, with the temporal superior quadrant being the most affected (72.5%) (Image A). In fellow eyes, arteriovenous nicking (60%) (Image B) was the most common finding, followed by microaneurysms (42.5%) (Image C), vessel tortuosity (30%) (Image D), prior vascular occlusive events (7.5%) (Image E), and macroaneurysms (5%) (Image F). Of note, microaneurysms were mostly observed in the far periphery of the contralateral eye. Only 22.5% of fellow eyes had no angiographic evidence of vascular pathology.
Ultra wide-field angiography provides evidence of retinal vascular pathology in a majority of fellow eyes of patients with BRVO. Visualizing the retinal vasculature in the fellow eye may provide insight into the cause of the vascular occlusion in the affected eye, identify vascular anomalies, and possibly predict future occlusive events in the fellow eye. This also emphasizes the need for strict management of associated conditions.
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