UTILITY OF ORAL FLUORESCEIN ANGIOGRAPHY WITH ULTRA-WIDEFIELD IMAGING SYSTEM FOR EVALUATION OF VARIOUS RETINAL DISORDERS

Abstract

Purpose: To evaluate the utility of oral fluorescein angiography with ultra-widefield imaging system (oral UWF-FA) predominantly in children.

Methods: We recruited 17 patients aged 2 years to 22 years with retinal disorders. Each patient ingested a dose of fluorescein sodium set by body weight mixed with 100 mL of juice. Images were scored using four parameters as follows: branch retinal vessel identification, retinal vessels visualization, foveal avascular zone visualization, and clinically important findings such as leakage, microaneurysms, neovascularization, or significant nonperfusion area visualization. Based on the aggregate score, we classified the image quality into three grades.

Results: Sixteen of 17 patients completely ingested the fluorescein sodium, and ultra-widefield fluorescein angiography was performed. Images were classified as high quality in nine cases, moderate quality in four, and poor quality in three. In 13 cases (81.3%), images had adequate quality to evaluate retinal conditions. Of three patients with poor-quality images, 2 took 10 minutes to ingest fluorescein sodium and the other ingested only half the dose. The adverse event of a mild skin rash was noted in one patient.

Conclusion: Oral ultra-widefield fluorescein angiography is effective in evaluating retinal pathology and is a useful alternative especially for pediatric patients who cannot tolerate intravenous line placement.