Comparison of wide-field fluorescein angiography and 9-field montage angiography in uveitis

Abstract

Purpose: To compare qualitatively and quantitatively Optos fundus camera fluorescein angiographic images of retinal vascular leakage with 9-field montage Topcon fluorescein angiography (FA) images in patients with uveitis. We hypothesized that Optos images reveal more leakage in patients with uveitis.

Design: Retrospective, observational case series.

Methods: Images of all patients with uveitis imaged with same-sitting Optos FA and 9-field montage FA during a 9-month period at a single institution (52 eyes of 31 patients) were graded for the total area of retinal vascular leakage. The main outcome measure was area of fluorescein leakage.

Results: The area of apparent FA leakage was greater in Optos images than in 9-field montage images (median 22.5 mm(2) vs 4.8 mm(2), P < 0.0001). Of the 49 (45%) eyes with gradable photos, 22 had at least 25% more leakage in the Optos image than in the montage image; 2 (4.1%) had at least 25% less leakage in Optos; and 25 (51%) were similar in the 2 modalities. There were 2 eyes that had no apparent retinal vascular leakage in 9-field montage but were found to have apparent leakage in Optos images. Of the 49 eyes, 23 had posterior pole leakage, and of these, 17 (73.9%) showed more posterior pole leakage in the Optos image. A single 200-degree Optos FA image captured a mean 1.50× the area captured by montage photography.

Conclusions: More retinal vascular pathology, in both the periphery and the posterior pole, is seen with Optos FA in patients with uveitis when compared with 9-field montage. The clinical implications of Optos FA findings have yet to be determined.

Published by Elsevier Inc.

Figures

Figure 1. Aligned, adjusted Optos and montage fluorescein angiogram images used for measurement of retinal vascular leakage in an eye with uveitis

(Top left and top right) The montage and Optos FA images from this eye with uveitis have been aligned using I2K and contrast-adjusted with Image J. (Middle left and right) Aligned and adjust images were then used to measure the area of FA leakage, which has been outlined here using Image J. Note that more FA leakage is seen in the Optos image than in the montage image. (Bottom left and right) The measured area of leakage is blocked out for emphasis

Figure 1. Aligned, adjusted Optos and montage fluorescein angiogram images used for measurement of retinal vascular leakage in an eye with uveitis

(Top left and top right) The montage and Optos FA images from this eye with uveitis have been aligned using I2K and contrast-adjusted with Image J. (Middle left and right) Aligned and adjust images were then used to measure the area of FA leakage, which has been outlined here using Image J. Note that more FA leakage is seen in the Optos image than in the montage image. (Bottom left and right) The measured area of leakage is blocked out for emphasis

Figure 1. Aligned, adjusted Optos and montage fluorescein angiogram images used for measurement of retinal vascular leakage in an eye with uveitis

(Top left and top right) The montage and Optos FA images from this eye with uveitis have been aligned using I2K and contrast-adjusted with Image J. (Middle left and right) Aligned and adjust images were then used to measure the area of FA leakage, which has been outlined here using Image J. Note that more FA leakage is seen in the Optos image than in the montage image. (Bottom left and right) The measured area of leakage is blocked out for emphasis

Figure 2. Comparison of a posterior pole late fluorescein angiogram image from a fundus camera with a posterior pole image from the Optos from the same eye with uveitis

A posterior pole late FA image from a fundus camera (left) is compared with a posterior pole late image from the Optos (right, cropped 200 degree image) in an eye with uveitis. Note that more FA leakage is seen on the Optos image taken in the same sitting as the fundus camera image.

Figure 2. Comparison of a posterior pole late fluorescein angiogram image from a fundus camera with a posterior pole image from the Optos from the same eye with uveitis

A posterior pole late FA image from a fundus camera (left) is compared with a posterior pole late image from the Optos (right, cropped 200 degree image) in an eye with uveitis. Note that more FA leakage is seen on the Optos image taken in the same sitting as the fundus camera image.