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V. Papastavrou, R. Gupta, J. Talks; Evaluation of Optomap P200MA Wide-Field Fluorescein Angiography for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4682.
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Diabetic retinopathy (DR) remains a leading cause of sight impairment. The use of Wide-field fluorescein angiography (wFFA) may provide better peripheral DR information than standard fundus angiography.
To assess the effectiveness of Optomap P200MA wFFA compared to slit lamp clinical examination of diabetic patients.
Patients with with severe pre-proliferate or proliferate DR underwent Optomap P200 wFFA. The photographs were assessed for quality, size of field and information obtained. The wFFA size of field was compared to the mean size of field on a 7 field montage angiogram of 8 (16 eyes) diabetic patients taken on a Zeiss fundus camera.
A total of 30 patients (53 eyes) were examined. 45/53 (85.7%) angiograms provided good quality images. 8 (14.3% ) were of a lesser quality due to peripheral distortion of the images due to media opacities, cataracts, eyelids, eyelashes and patient movement.The mean Zeiss fundus camera 7 field montage angiogram area was 16x14 disc diameters (DD) of field. Mean wFFA horizontal and vertical image size clearly seen was 21.5 DD (range 15.6-27.6) and 11.8 DD (range 8.5-15.6) respectively. In 4 images the total measured image size was limited by eye lash artifact.In 38/53 eyes (71.4%), wFFA revealed sectorial peripheral ischemia. In 4 eyes, diagnosed with severe non proliferate diabetic retinopathy on slit lamp examination, neovascularisation was revealed on wFFA.
A high percentage of quality wFFA can be obtained but image artifact remains an issue. This is likely to improve with better patient cooperation and user skill. The mean field of view in the horizontal axis is larger than the mean Zeiss fundus camera 7 field montage horizontal field.Angiographic documentation of actual peripheral retinal ischemia and localization of unseen neovascularisation on slit lamp examination may allow targeted laser pan retinal photocoagulation therapy.
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