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FLUORESCEIN ANGIOGRAPHY EVALUATION OF CHILDREN PREVIOUSLY TREATED WITH ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR
Fatma Poslu Karademir1,2, Aslı Vural2, Mehmet Özbaş2
1Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; and.
Insights
Fluorescence angiography reveals significant peripheral vascular abnormalities in eyes treated for aggressive retinopathy of prematurity. This imaging technique aids in detecting issues missed by indirect ophthalmoscopy, potentially preventing vision loss.
Area of Science:
- Ophthalmology
- Medical Imaging
- Neonatology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Aggressive ROP requires timely and effective treatment, often involving anti-vascular endothelial growth factor (anti-VEGF) therapy.
- Understanding peripheral vascular changes post-treatment is crucial for managing ROP.
Purpose of the Study:
- To assess vascularization and peripheral vascular findings using fluorescence angiography in patients with aggressive or Type 1 ROP post-anti-VEGF treatment.
- To evaluate the diagnostic capabilities of fluorescence angiography in detecting subtle vascular abnormalities.
Main Methods:
- Retrospective analysis of fluorescence angiography data from 250 patients (486 eyes) treated for ROP.
- Inclusion criteria: first fluorescence angiography at 1 year or older.
- Data collected on vascular termination zones, distance to ora serrata, and specific vascular anomalies.
Main Results:
- Vascular termination occurred in Zone II (17.1%) and Zone III (82.9%).
- Abnormal vascular findings were prevalent: circumferential vessels (41.2%), finger-like projections (36.2%), hyperfluorescence (16.9%), fine branching/blunt termination (15%), and arteriovenous shunts (9.9%).
- A significant percentage of eyes showed vascular terminals within two disk diameters of the ora serrata (62.7%).
Conclusions:
- Late-stage fluorescence angiography effectively visualizes vascular termini and detects abnormalities missed by indirect ophthalmoscopy.
- This imaging modality is valuable for monitoring ROP treatment and preventing vision-threatening complications.
- Routine follow-up with fluorescence angiography can improve patient outcomes in aggressive ROP.
Purpose:
To determine the level of vascularization and peripheral vascular findings by fluorescence angiography in patients with aggressive retinopathy of prematurity or Type 1 retinopathy of prematurity treated with a single dose of anti-vascular endothelial growth factor.
Methods:
Data of patients referred to the authors' clinic for fluorescence angiography examination between June 2016 and September 2021 were retrospectively analyzed. Patients who had their first fluorescence angiography examination at the age of 1 year or older were included in the study.
Results:
A total of 486 eyes of 250 patients were included. Of these, 83 eyes (17.1%) had vascular termination in Zone II and 403 eyes (82.9%) in Zone III. In 62.7% of eyes, the distance from the vascular terminals to the temporal ora serrata was less than two disk diameters, and in 20.2%, it was more than two disk diameters. Abnormal vascular findings were noted, including circumferential vessels (41.2%), finger-like projection anomaly (36.2%), hyperfluorescence (16.9%), fine branching and blunt termination (15%), and arteriovenous shunt (9.9%).
Conclusion:
Fluorescence angiography performed late in the course of treatment can clearly define the vascular termini and detect abnormalities that cannot be detected by indirect ophthalmoscopy. Follow-up with fluorescence angiography can help prevent complications that can lead to vision loss.
