Application of ultra-widefield fluorescein angiography in fundus diseases

Abstract

Objective To study the clinical application of Heidelberg ultra-widefield fluorescein angiography (UWFA) and compare the feasibility of Heidelberg UWFA and Heidelberg 55° fundus fluorescein angiography (FFA) in visualizing fundus lesions peripherally and posteriorly. Methods A total of 124 consecutive patients (248 eyes) undergoing Heidelberg UWFA and 55°FFA in Zhongshan Ophthalmic Center during December 2014 to January 2015 were retrospectively analyzed. The view field areas and fundus lesions of FFA captured using Heidelberg ultra-widefield lens and Heidelberg 55° lens were compared. Results The UWFA imaging module visualized a 150° view field of the fundus in a single photograph, which captured 3.2× the area captured by a single 55° FFA image. A five-field protocol of UWFA images was sufficient to cover the whole fundus. UWFA was superior in showing the far peripheral retina, especially in the nasal and inferior quadrants, which were difficult to image using 55° FFA. Peripheral retinal lesions such as peripheral retinal degeneration, vascu-lar leakage, nonperfusion area, microaneurysm, and retinal neovascularization were better visualized using UWFA. However, UWFA failed to show the details of the posterior lesions. Conclusions Appropriate lens should be chosen based on the features of the studied lesion. UWFA is the optimal choice for imaging lesions at the far peripheral retina, enabling efficient diagnosis and monitoring of the fundus diseases involving the peripheral retina. 55° FFA is better in showing posterior retinal lesions. Key words: Ultra-widefield; Fundus fluorescein angiography; Far peripheral retina