Abstract
Purpose :
Optic nerve (ON) pathologies can present a diagnostic challenge in paediatric populations. Fundus fluorescein angiography (FFA) is a good diagnostic tool but can be difficult in children given the intravenous administration. Oral FFA (oFFF) is a less invasive alternative with superior imaging using an ultrawide field (UWF) retinal camera. This review aimed to demonstrate the safety profile of established oFFA protocol, characterise the ON pathology and compare the diagnostic accuracy of specialist clinicians versus trainee ophthalmologists in interpreting oFFA studies.
Methods :
A retrospective review was conducted of paediatric patients undergoing optic nerve evaluation using oFFA with images taken at 15min, 30 min, and 45 minute timepoints between 2019 and 2022. Four cardinal oFFA characteristics were identified: Normal nerve appearance, Papilloedema, ON head drusen and, uveitic papillitis. Test sensitivity and specificity was determined by a survey of attending and resident ophthalmologists, from across the East of England, who completed a blinded interpretation of 15 oFFA images with one of four diagnoses. Graphpad prism was used as statistical software for the study.
Results :
oFFA series from 30 eyes (13 children) were identified, age ranging from 7-15 years. Our protocol produced good quality imaging while generating 0% adverse side-effects. User survey reveal very good sensitivity and specificity in distinguishing normal from abnormal ON for both attendings and trainee ophthalmologists. Qualitative and quantitative feedback supported the task as a useful exercise.
Conclusions :
oFFA with UWF imaging are a safe and effective imaging adjunct in diagnostically challenging ON pathology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.