Elsevier

Ophthalmology

Volume 117, Issue 4, April 2010, Pages 780-784
Ophthalmology

Original article
Ultra Wide-Field Angiographic Characteristics of Branch Retinal and Hemicentral Retinal Vein Occlusion

Presented at: the 26th Annual Meeting of the American Society of Retina Specialists, Maui, Hawaii, October 13, 2008.
https://doi.org/10.1016/j.ophtha.2009.09.019Get rights and content

Purpose

To study the peripheral angiographic features of branch retinal vein occlusions (BRVO) and hemicentral retinal vein occlusions (HRVO) and explore associations with macular edema and neovascularization.

Design

Retrospective observational case series.

Participants

Seventy-eight outpatients.

Methods

An imaging database of angiograms performed at a single academic institution was searched for patients with a diagnosis of BRVO or HRVO. Images were graded for the presence of untreated nonperfusion (areas without evidence of laser photocoagulation), late peripheral vascular leakage (LPVL), neovascularization, macular edema, and prior laser treatment. Optical coherence tomography images were reviewed for all patients to confirm the presence of macular thickening and to exclude eyes with vitreomacular traction.

Main Outcome Measures

Angiographic evidence of nonperfusion, neovascularization, macular edema, LPVL, and prior laser treatment.

Results

Angiograms from 80 eyes of 78 patients were analyzed with a diagnosis of BRVO (86%) or HRVO (14%). Angiographic macular edema (80%), untreated nonperfusion (82%), neovascularization (21%), and LPVL (58%) were observed. Untreated nonperfusion at any location was significantly associated with macular edema (P = 0.043). Untreated nonperfusion anterior to the globe equator was significantly associated with macular edema (P = 0.007). Untreated nonperfusion was significantly associated with the presence of neovascularization (P = 0.033). Late peripheral vascular leakage was not associated with other angiographic or clinical findings studied.

Conclusions

Ultra wide-field angiography provides visualization of peripheral retinal pathology in BRVO and HRVO patients, which may be useful in their evaluation and treatment. Our findings support the hypothesis that areas of untreated retinal nonperfusion may be the source of production of biochemical mediators that promote neovascularization and macular edema.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Methods

We conducted a retrospective review of all ultra wide-field fluorescein angiograms performed for the evaluation of a primary diagnosis of BRVO or HRVO at a single academic institution. All images were obtained with the Optos C200 MA (Optos, PLC) after standard intravenous infusion of 5 cc of sodium fluorescein 10%. Images were digitally archived and reviewed using the V2 Vantage Review Software (Optos, PLC) allowing high-resolution zoom functionality for the review of all images.

A single,

Results

A total of 80 ultra wide-field fluorescein angiograms from 78 patients were reviewed. Four angiograms could not be interpreted owing to poor quality and were not included in the analysis. Of the 76 angiograms analyzed, BRVO was the primary diagnosis in 65 eyes (86%) and HRVO was the primary diagnosis in 11 eyes (14%). The demographic data for patients in this analysis are summarized in Table 1. Of note, a total of 15 patients had prior intravitreal injection with ≥1 anti-VEGF agent (n = 10) or

Discussion

To our knowledge, this is the first study utilizing ultra wide-field fluorescein angiography to analyze peripheral retinal vascular pathology in patients with retinal vascular occlusive disorders. Although the pathogenic sites of HRVO and BRVO are different,8 we chose to include both retinal vascular occlusive disorders in this study because the evaluation and management of BRVO and HRVO are often similar. We opted to include eyes with evidence of prior laser photocoagulation for 2 reasons.

References (12)

There are more references available in the full text version of this article.

Cited by (0)

Manuscript no. 2009-734.

Financial Disclosure(s): The authors have made the following disclosures: Scott Oliver - consultant and on the speaker's bureau - Optos, PLC Steven Schwartz - consultant and on the speaker's bureau - Optos, PLC

Supported by the Frederic G. Rappaport Fellowship Award (to Scott C.N. Oliver, MD) and the Price Foundation Retina Research Fund (Pradeep Prasad, Jean-Pierre Hubschman, and Steven D. Schwartz).

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