scholarly journals Fluorescein Angiography, Wide Field Angiography, and Indocyanine Green Angiography in Behcet Uveitis

In Behcet's disease, the anterior and posterior segments of the eye may be affected separately or together. Fundus fluorescein angiography should be performed in addition to ophthalmoscopic examination for early diagnosis and treatment of ocular involvement. Fundus fluorescein angiography (FFA) is the gold standard for the evaluation of the retinal vascular system and pathologies. Fundus fluorescein angiography is more sensitive than fundus examination in the detection of vasculitis, and angiographic involvement is always more common than clinical involvement. Fluorescein angiography may reveal leakage from retinal veins in eyes whose visual impression is not affected and the fundus examination is normal. The absence of vascular leakage with fluorescein angiography indicates that the disease is in a completely inactive period. Because of the development of blindness due to posterior segment involvement, early detection of the disease with fundus angiography and the initiation of the treatment is successful in terms of visual prognosis. It has an important place in terms of early activation of patients with FFA in the early diagnosis of eye involvement and follow-up of the disease and treatment. Wide-field imaging angiography imaging of the retinal periphery revealed the importance of lesions in retinal periphery and peripheral areas invisible by standard angiography. The use of indocyanine green angiography in Behcet uveitis is limited.

The term of pachychoroid spectrum diseases is used to identify a group of diseases that are characterized by increase of choroidal thickness. The increase of choroidal thickness is caused by dilated vascular vessels in Haller’s layer and accompanied by thinning in the choriocapillaris and Sattler’s layer. The presence of characteristic morphological changes including structural and functional choroidal changes is the key pathophysiological basis for the identification of pachychoroid diseases. The spectrum of pachychoroid disease consists of different clinical manifestations that can progress from one to another. Multimodal imaging methods are used in the diagnosis, treatment, and follow-up of these diseases. In this review, color fundus photographs, fundus fluorescein angiography, and indocyanine green angiography characteristics of pachychoroid diseases are discussed.


2019 ◽  
Vol 236 (04) ◽  
pp. 492-510 ◽  
Author(s):  
Sina Elahi ◽  
Carl Herbort

AbstractThe purpose of this work was to give a comprehensive and updated review on two primary stromal choroiditis entities, Vogt-Koyanagi-Harada disease (VKH) and birdshot retinochoroiditis (BRC). Their appraisal has become much more precise thanks to new investigational methods, such as indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT), which give substantially improved imaging access to the choroid. In this review, we focus on the crucial changes brought by this progress in the understanding, diagnosis, and management of these disorders. Application of these methods makes it possible to reach an early diagnosis, therefore allowing early treatment, which has led to a profound improvement in outcomes when compared to previous management.


Author(s):  
Ryo Kurobe ◽  
Yoshio Hirano ◽  
Naomi Niwa ◽  
Kazuhiko Sugitani ◽  
Tsutomu Yasukawa ◽  
...  

2019 ◽  
pp. 112067211989242 ◽  
Author(s):  
Pierluigi Iacono ◽  
Maurizio Battaglia Parodi ◽  
Sandro Saviano ◽  
Mariacristina Parravano ◽  
Monica Varano

Purpose: To report the morphological and clinical features of a case of pachychoroid disease with focal choroidal excavation and large choroidal excavation complicated by choroidal neovascularization. Methods: The patient underwent a complete ophthalmologic examination including best-corrected visual acuity assessment, anterior segment and dilated fundus examination, fluorescein and indocyanine green angiography, and spectral-domain optical coherence tomography. Results: During the previous follow-up, the 57-year-old man received a diagnosis of central serous chorioretinopathy in the right eye with a late appearance of a choroidal neovascularization. The best-corrected visual acuity was 20/125 and 20/20 in the right and left eye, respectively. Dilated fundus examination, fluorescein angiography, and indocyanine green angiography confirmed a large subretinal fibrosis corresponding to the evolution of the choroidal neovascularization in the right eye. Spectral-domain optical coherence tomography clearly demonstrated in the right eye a large choroidal excavation below the fibrotic neovascular lesion with multiple hyperreflective foci inside the cavity, and in the left eye, a conforming focal choroidal excavation, bowl-shape type, associated with increased choroidal thickness with pachyvessels. Conclusion: Large choroidal excavation has been rarely reported. Although the pathogenetic mechanisms leading to the formation of large choroidal excavation are still only hypotheses, a combination of primary degenerative inflammatory factors sustaining the focal choroidal excavation formation and disruptive process of the choroidal neovascularization could be retained responsible for the large choroidal excavation.


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