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Carolyn K. Pan, Valentina Franco-Cardenas, Gad Heilweil, Irena Tsui, Jean-Pierre Hubschman, Steven D. Schwartz; Ultra Wide-Field Angiography Characteristics of Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2676.
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To study the pattern of angiographic retinal non-perfusion in ischemic central retinal vein occlusion (CRVO).
Retrospective observational case series. An imaging database of ultra wide-field fluorescein angiograms (UWFFA) performed at a single academic institution was searched for the diagnosis of CRVO. Patients included had treatment-naïve CRVO with evidence of non-perfusion defined as capillary dropout. The angiograms were divided into 3 distribution areas (central, equatorial, and peripheral) and 4 quadrants (superotemporal, inferotemporal, inferonasal, and superonasal). Areas of non-perfusion were identified on the UWFFA and classified based on both the distribution area and the quadrant(s) affected. Charts were reviewed for demographic and clinical information.
Of the first 200 CRVO angiograms reviewed, 33 treatment-naïve ischemic CRVO patients were identified and 35 eyes studied. Patient age ranged from 30 to 96 years (mean 71 years; SD 16 years). Non-perfusion was most commonly seen in the superotemporal (100%) and inferotemporal (91.4%) quadrants. Individual comparisons of the presence of non-perfusion in these quadrants to inferonasal and superonasal quadrants (both 65.7%) were statistically significant (p < 0.05). 100% of non-perfusion involved peripheral distribution, compared with 51.4% and 37.1% involving equatorial and central distribution, respectively (p < 0.001). There was no statistically significant difference in the quadrants of non-perfusion when looking at the central and equatorial distribution areas individually; however, the peripheral distribution mirrored the overall angiographic findings as described above.
UWFFA provides visualization of retinal ischemia in eyes with CRVO that may otherwise be missed with conventional fluorescein angiography. This study suggests that capillary dropout is most commonly seen in the peripheral temporal quadrants.
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