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. 2024 May 29;4(6):100561.
doi: 10.1016/j.xops.2024.100561. eCollection 2024 Nov-Dec.

Fluorescein Angiography Parameters in Premature Neonates

Natasha F S da Cruz  1 , Sandra Hoyek  2 , Jesse D Sengillo  1 , Ana Rodríguez  3 , Giselle de Oliveira  1 , Catherin I Negron  1 , Nimesh A Patel  2 , Audina M Berrocal  1
Affiliations

Fluorescein Angiography Parameters in Premature Neonates

Natasha F S da Cruz et al. Ophthalmol Sci. .

Abstract

Purpose: To describe fluorescein angiography (FA) parameters observed in premature neonates with retinopathy of prematurity (ROP).

Design: Retrospective case series.

Subjects: Patients with ROP who underwent FA imaging using Retcam at Holtz Children's Hospital from November 2014 to October 2022.

Methods: Fluorescein angiography images of the included patients were analyzed with a focus on the timing of angiography phases, including choroidal flush, retinal, and recirculation phases. Gestational age, birth weight (BW), age at imaging, treatment choice, and any FA complications were documented.

Main outcome measures: Dose of fluorescein administered, onset and duration of each angiography phase, and FA findings in ROP-treated patients.

Results: A total of 72 images of 72 eyes were reviewed. Image quality was deemed suitable for inclusion in 64 eyes (88.9%) of 43 patients. The mean gestational age and BW at birth were 24.4 ± 1.9 weeks and 607.8 ± 141.3 g, respectively. The mean postmenstrual age at FA imaging was 50.5 ± 40.8 weeks. All eyes (100%) received treatment with intravitreal injection of anti-VEGF at a mean age of 35.5 ± 2.4 weeks. The onset and duration of angiography phases were relatively variable within the cohort. Choroidal flush occurred at a mean time of 12.2 seconds (range: 6-22 seconds). A subsequent retinal phase was documented at a mean time of 11.96 seconds (range: 3-22 seconds). Recirculation phase was complete at an average time of 2.15 minutes (range: 1-5.45 minutes) postfluorescein injection. None of patients developed allergic reactions to fluorescein injection, such as rash, respiratory distress, tachycardia, fever, or local injection site reactions.

Conclusions: Angiographic phases on FA in preterm infants with ROP are variable and may occur earlier than the established references for adults.

Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Fluorescein angiography; Neonates; Retinopathy of prematurity.

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Figures

Figure 1
Figure 1
Standardized protocol for fluorescein angiogram acquisition in premature infants.
Figure 2
Figure 2
Representative fluorescein angiograms of a premature neonate showing the 4 phases: (A) choroidal flush, (B) retinal phase, (C) peak phase, and (D) recirculation phase.
Figure 3
Figure 3
Representative fluorescein angiogram of a premature neonate showing the leakage from a tunica vasculosa lentis.
See this image and copyright information in PMC

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