The application of ultra-wide-field angiography in the evaluation and management of patients with posterior, and panuveitis

Abstract

Objective: To evaluate the clinical application of ultra-wide-field fluorescein angiography in posterior and panuveitis patients. Methods: It's a prospective, observational case series study. A total of 82 eyes of 42 patients conformed to the research criteria of posterior and panuveitis. Clinical examinations, conventional fluorescein angiography and ultra-wide-field fluorescein angiograms were performed for each patient. The main outcome was the detection of peripheral retinal changes by ultra-wide-field fluorescein angiography, and how these changes influenced the evaluation and management of the disease. Results: There were 22 male and 20 female in the 42 patients. The mean age of the patients was (43±21) years. Twelve eyes (6 patients) were diagnosed as posterior uveitis, and 70 eyes (36 patients) as panuveitis. Clinical examinations and conventional fluorescein angiography detected active inflammation in 30 eyes (37%), while ultra-wide-field fluorescein angiography identified active inflammation in 48 eyes (59%). In these 18 additional eyes (22%) with active inflammation found by ultra-wide-field fluorescein angiography, non-perfusion area was observed in 4 eyes (5%) and neovascularization was observed in 1 eye (1%). By means of ultra-wide-field fluorescein angiography, a larger area of peripheral vessel leakage showed in 10 eyes (12%) which judged as active inflammation by conventional fluorescein angiography. Additional angiographic changes showed in 46%(21/45) of the eyes with clear etiology, while only in 19%(7/37) of the eyes without clear etiology. According to these findings, treatment strategies adjusted for 12 patients. Conclusions: Ultra-wide-field fluorescein angiography detected more peripheral retinal vascular pathology than conventional fluorescein angiography. The changes found in the periphery were important in the management of uveitis. (Chin J Ophthalmol, 2016, 52: 924-928).