Expert consensus on fundus fluorescein angiography reporting in ophthalmology: a Delphi study

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Vascular Diseases

Background:

• Fundus fluorescein angiography (FFA) is a key tool for retinal vascular disease diagnosis.
• The comparative utility of FFA versus optical coherence tomography angiography (OCTA) and standardized terminology remain unclear.
• Expert preferences for FFA and OCTA require clarification.

Purpose of the Study:

• To establish expert consensus on clinical indications for FFA compared to OCTA.
• To provide consensus definitions for key FFA angiographic terms.
• To clarify the role of FFA in the current era of advanced imaging.

Main Methods:

• A two-round modified Delphi process was employed.
• 25 retinal subspecialists provided input on clinical indications and terminology.
• Consensus was defined as ≥80% agreement.

Main Results:

• FFA is preferred for diagnosing retinal vasculitis, ocular ischemic syndrome, and proliferative diabetic retinopathy.
• FFA is favored for guiding laser photocoagulation in branch retinal vein occlusion.
• FFA was deemed non-essential for neovascular age-related macular degeneration and mild-to-moderate non-proliferative diabetic retinopathy. Consensus was reached on seven FFA terms.

Conclusions:

• This study offers current expert perspectives on FFA indications alongside OCTA.
• A consensus-based lexicon for FFA reporting in retinal vascular diseases was established.
• Standardized terminology enhances clarity in reporting FFA findings.