Fluorescein angiography after treatment of retinopathy of prematurity

Author: Joana Roque (Portugal)

Co-authors: Susana Henriques, Ana Sofia Lopes, Mafalda Mota, Graça Pires, Susana Teixeira, Isabel Prieto

Purpose

To assess the role of Fluorescein Angiography (FA) in the follow-up of premature infants treated for Retinopathy of Prematurity (ROP).

Setting/Venue

Hospital Prof. Doutor Fernando Fonseca, Amadora, Lisbon Portugal

Methods

Retrospective analysis of a series of color fundus photographs and FA images captured with RetCam from children previously treated for severe ROP at our hospital.

Results

We analyzed the color fundus photographs and FA images performed during the follow-up of 6 children (n=12 eyes) previously treated for severe ROP. FA was performed from the age of 6 months to 9 years-old (mean age 24,8 months). Treatment of ROP was: LASER photocoagulation (n=5), vitrectomy+LASER (n=1) and bevacizumab intravitreal injection (n=6). Eyes submitted to LASER treatment did not show recurrence of disease. Among the eyes treated with intravitreal injection, 2 developed recurrent disease, which was evidenced by peripheral exudation on FA. These infants consequently underwent LASER ablation of avascular retina. The remaining eyes did not show recurrence of the disease, but FA images revealed extensive areas of avascular peripheral retina, even several years after treatment of ROP. Overall, FA images enabled a remarkably better characterization of retinal vascularization when compared to color fundus images. This angiographic exam showed a wide variety in retinal circulation and choroidal filling patterns, the most frequent finding being anomalous branching at the level of small arterioles (100%).

Conlusions

FA performed after treatment of ROP revealed abnormal vascular patterns in all eyes. Eyes treated with bevacizumab injection alone showed extensive areas of avascular peripheral retina on FA, even several years after treatment of ROP. This exam provided an excellent characterization and documentation of vascular anomalies, proving to be a valuable tool in the follow-up of these children.

Financial Disclosure

No finantial interests

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