Purchase this article with an account.
Michael T. Trese, Amir H. Kashani, Antonio Capone, Jr., Kimberly A. Drenser; Wide Field Angiography in Diagnosis and Management of Familial Exudative Vitreoretinopathy (FEVR). Invest. Ophthalmol. Vis. Sci. 2012;53(14):4161.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To explore the role of wide-field imaging and angiography in the diagnosis and management of FEVR
Retrospective review of patient records (July 2011 to December 2011) with diagnosis of FEVR at a single, multi-physician, subspeciality, pediatric retina practice. Only patients with clinical examination and wide-field imaging and angiography results were included in this study.
Fourteen patients (24 eyes) with clinical diagnosis of FEVR (stages ranging from 1-5) underwent wide-field imaging and angiography (Optos Inc). The patient population was 28% male. Average age was 23 (range 1-60 years old). Average LogMAR visual acuity in 24 eyes was 0.31 (20/41 Snellen) and ranged from 0 to no light perception (NLP). Two eyes with prosthesis and four others that were NLP were excluded from the study. Here we report a number of distinguishing peripheral vascular patterns not easily observed with standard clinical examination or fundus photography. These include variably avascular areas in the periphery (Figure 1A), small areas of bulbous-like vascular changes (Figure 1A), capillary staining and leakage (Figure 1A), and neovascularization (Figure 1B). Wide-field imaging also reveals exquisite details in patients with subretinal exudation (Figure 1B), macular dragging (Figure 1B), exudative and tractional retinal detachment (Figure 1B).
The most disturbing feature of FEVR is that it shows the potential for unpredictable, lifelong reactivation from any stage. Reactivation is often heralded by leakage and staining of capillaries that are not easily observed on clinical exam or standard fundus photography. The use of serial wide-field angiography is very helpful for diagnosis early disease (stage 1) and equally helpful for close management of more advanced disease (stage 2) which may require image guided laser therapy.
This PDF is available to Subscribers Only