Wide-field fundus fluorescein angiogram assisted photocoagulation on familial exudative vitreoretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

LiYian , ZhangQi , PengJie , HuangQiujing , LiXin ,  ZhaoPeiquan

Department of Ophthalmology, Xinhua Hospital Afflilliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China;

Corresponding author：

ZhaoPeiquan, Email: zhaopeiquan@126.com

Keywords：

Retinal diseases/congenital; Retinal diseases/diagnosis; Fluorescein angiography; Retinal diseases/therapy; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2016.03.005

Video：

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Objective To observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (RetcamⅢ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR). Methods The study included 46 eyes of 34 patients with staging 2 FEVR. All patients received color fundus photography and FFA under general anesthesia. The blood vessel reliability of color fundus photography and FFA was comparatively determined. Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA, the wavelength was 532nm, the duration was 0.25 s and the energy was 200-280 mW. After laser photocoagulation, fundus imaging and FFA was repeated. Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation. After treatment, the mean follow-up duration was 14.4 months. The follow up focused on neovascularization, exudative lesions, vitreous traction and merging of photocoagulation spots within 3 months, and on fibrosis membrane resulting in macular traction, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. Results It was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed. Neovascularization can't be determined by shape of the blood vessels. On the other hand, those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone. The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope. During the treatment, there was no retinal FEVR area missed laser photocoagulation for all patients. There was no neovascularization, exudative lesions, vitreous traction within 3 months, and no fibrosis membrane, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. There were no ocular and systemic complications during and after the FFA and laser photocoagulation. Conclusion Wide-field RetcamⅢFFA can help retinal specialists to identify abnormal neovascularization, locate the lesion area, and thus increase the success rate of laser photocoagulation, reduce the ocular and systemic complications for FEVR.

Citation： LiYian, ZhangQi, PengJie, HuangQiujing, LiXin, ZhaoPeiquan. Wide-field fundus fluorescein angiogram assisted photocoagulation on familial exudative vitreoretinopathy. Chinese Journal of Ocular Fundus Diseases, 2016, 32(3): 248-251. doi: 10.3760/cma.j.issn.1005-1015.2016.03.005 Copy

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9.	蔡璇, 张琦, 许宇, 等. 家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征[J]. 中华眼底病杂志, 2014, 30(1):92-94. DOI:10.3760/cma.j.issn.1005-1015.2014.01.026.Cai X, Zhang Q, Xu Y, et al. Characteristics of fundus fluorescein angiography in familial exudative vitreoretinopathy[J].Chin J Ocul Fundus Dis, 2014, 30(1):92-94. DOI:10.3760/cma.j.issn.1005-1015.2014.01.026.

1. Shukla D, Singh J, Sudheer G, et al. Familial exudative vitreoretinopathy (FEVR):clinical profile and management[J]. Indian J Ophthalmol, 2003, 51(4):323-328.
2. Lepore D, Molle F, Pagliara MM, et al. Atlas of fluorescein angiographic findings in eyes undergoing laser for retinopathy of prematurity[J]. Ophthalmology, 2011, 118(1):168-175. DOI:10.1016/j.ophtha.2010.04.021.
3. 中华医学会眼科学分会眼底病学组. 中国早产儿视网膜病变筛查指南(2014)[J]. 中华眼科杂志, 2014, 50(12):5. DOI:10.3760/cma.j.issn.0412-4081.2014.12.017.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Chinese retinopathy of prematurity screening guidelines (2014)[J].Chin J Ophthalmol, 2014, 50(12):5. DOI:10.3760/cma.j.issn.0412-4081.2014.12.017.
4. Pendergast SD, Trese MT. Familial exudative vitreoretinopathy:results of surgical management[J]. Ophthalmology, 1998, 105(6):1015-1023.
5. Blair MP, Shapiro MJ, Hartnett ME. Fluorescein angiography to estimate normal peripheral retinal nonperfusion in children[J]. J AAPOS, 2012, 16(3):234-237. DOI:10.1016/j.jaapos.2011.12.157.
6. 陶媛, 董宇,李松鹤,等. 810 nm激光治疗早产儿视网膜病变疗效分析[J]. 中国实用眼科杂志, 2014, 32(3):210-212. DOI:10.3760/cma.j.issn.1006-4443.2014.02.030.Tao Y, Dong Y, Li SH, et al. Treatment outcome for retinopathy of premeturity by 810 nm diode laser photocoagulation[J].Chin J Pract Ophthalmol, 2014, 32(3):210-212. DOI:10.3760/cma.j.issn.1006-4443.2014.02.030.
7. Levinson JD, Hubbard GB 3rd. 577 nm yellow laser photocoagulation for coats disease[J]. Retina, 2015,2015:E1.http://dx.doi.org/10.1097/IAE.0000000000000874. DOI:10.1097/IAE.0000000000000874..
8. Sisk RA. Intravenous sodium fluorescein 10% for laser ablation of subtle retinal neovascularization in FEVR[J]. J Pediatr Ophthalmol Strabismus, 2012, 49(2):126-127. DOI:10.3928/01913913-20111214-01.
9. 蔡璇, 张琦, 许宇, 等. 家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征[J]. 中华眼底病杂志, 2014, 30(1):92-94. DOI:10.3760/cma.j.issn.1005-1015.2014.01.026.Cai X, Zhang Q, Xu Y, et al. Characteristics of fundus fluorescein angiography in familial exudative vitreoretinopathy[J].Chin J Ocul Fundus Dis, 2014, 30(1):92-94. DOI:10.3760/cma.j.issn.1005-1015.2014.01.026.

Chinese Journal of Ocular Fundus Diseases

Wide-field fundus fluorescein angiogram assisted photocoagulation on familial exudative vitreoretinopathy

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