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S.D. Schwartz, A. Gupta, C.R. Gonzales, T.A. Young, D. Telander, C. Mango, R. Wirthlin, A.E. Kreiger; Peripheral Retinal Ischemia Associated With Diffuse Diabetic Macular Edema Identified With Widefield Angiography. . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4793.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the utility of the 200 degree Optos 200A Widefield Angiography System compared to standard 30–degree digital fluorescein angiography in the evaluation of patients with diabetic retinopathy. Methods: Ten patients with diabetic retinopathy and clinically significant macular edema were evaluated angiographically with standard 30–degree fluorescein angiography and with the Optos 200A widefield angiography system, performed one week apart. Bilateral images were obtained for all patients. The angiograms were evaluated for evidence of focal or diffuse macular edema, capillary non–perfusion, intraretinal microvascular abnormalities, and neovascularization. Results: All ten patients demonstrated angiographic features of nonproliferative diabetic retinopathy in both eyes with the 30–degree and widefield angiographic systems. Among the primary transit eyes, nine of 10 demonstrated features consistent with clinically significant macular edema and five of those had diffuse angiographic macular edema. All five patients with diffuse macular edema were noted to have peripheral capillary non–perfusion detected with the widefield system, that was not appreciated by standard 30–degree angiography. One of the five patients with diffuse macular edema had peripheral neovascularization imaged only with the widefield system. The remaining five patients with focal macular edema had no angiographic evidence of peripheral capillary non–perfusion with either angiographic system. Conclusions: The quality of images obtained with the Optos 200A Widefield Angiographic system and the utility of the software exceeded expectations. Although the number of patients in this study was small, an interesting clinical association was detected using the widefield angiographic system; namely, diffuse macular edema in patients with non–proliferative diabetic retinopathy seems to be associated with substantial peripheral capillary non–perfusion, whereas eyes with focal macular edema do not tend to have detectable peripheral retinal ischemia. The Optos 200A Widefield Angiography System may offer a distinct advantage over standard 30–degree fluorescein angiography by allowing evaluation of the retinal periphery through all phases of the fluorescein angiogram.
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