Abstract
Purpose: :
To describe the adjunctive use of fundus fluorescein angiography (FFA) in diagnosis and management of severe retinopathy of prematurity (ROP).
Methods: :
We performed FFA in premature infants undergoing treatment for type 1 ROP including Aggressive Posterior ROP. Features typical of APROP including presence of arteriovenous shunts associated with areas of vaso-obliteration and prominence of plus disease in absence of a ridge were identified as main indications for FFA. Digital imaging and FFA (10% sodium Fluorescein solution, 0.078 ml/kg) were performed using RetCam II (Clarity Medical Systems). Infants were monitored for any adverse reactions post injection of fluorescein for atleast 4 hours and during delivery of laser treatment.
Results: :
FFA findings confirmed presence of severe ROP including:• presence of arteriovenous loops in peripheral retina in absence of a visible capillary network• wedge-shaped defect in temporal retina in posterior ROP• leakage from retinal vessels associated with clinical stage 2 and 3• persistence of tunica vasculosa lentis which may be continuous with the hyaloid artery systemClinical observation of absence of small caliber retinal vessels was correlated with angiographic signs of vaso-obliteration, confirming significant ischemia within areas of vascularized retina in severe disease.No adverse events were encountered as a result of administration of fluorescein in our patients.
Keywords: retinopathy of prematurity • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)