The utility of ultra-widefield fluorescein angiography in pediatric retinal diseases

Abstract

Background: Ultra-widefield angiography is the latest technology in the evolution of fundus fluorescein angiography. With the ability to capture up to 200° of the fundus in a single image, far peripheral retinal pathology can be imaged. Generally, obtaining high-quality fundus fluorescein angiography in a child without sedation in the outpatient setting is exceedingly challenging. Therefore, there are advantages to imaging platforms that can capture the peripheral retina in young children without anesthesia. Often pediatric retinal diseases have pathology localized to the far periphery, which further validates the utility of ultra-widefield angiography. Ultra-widefield angiography has been successfully used without sedation for evaluation of children with various pediatric retinal diseases such as Coats disease, familial exudative vitreoretinopathy, and retinopathy of prematurity.

Conclusion: This non-contact, non-mydriatic modality has been utilized in the evaluation of pediatric retinal diseases and demonstrated to have benefits over conventional fluorescein angiography techniques.

Keywords: Coats disease; Familial exudative vitreoretinopathy; Incontentia pigmenti; Pediatric retina; Retinopathy of prematurity; Ultra-wide field imaging; Ultra-widefield fluorescein angiography.

Fig. 1

Representative photo of ultra-widefield angiography of two children with familial exudative vitreoretinopathy. a Right eye of a 9 year old child with persistent retinal nonperfusion posterior to prior laser photocoagulation. b Left eye of a 10 year old child with prominent temporal vascular dragging, hyperfluorescence and leakage from neovascularization

Fig. 2

Representative photo of ultra-widefield angiography in an 8 year old child with Coats disease. Laser photocoagulation was performed previously to telangiectatic vessels and there is staining of chronic exudation in the superior macula