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    New technology takes invisibility cloak off in retinal imaging

    New imaging technologies are now available that have changed the way retina specialists evaluate patients, revealing structures that previously could not be visualized. 

    This increased diagnostic capability provided by ultra-widefield fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) allows physicians to go where they could not previously go in the detection and treatment of retinal diseases.

    Ultra-widefield FA

    There are primarily two non-contact, ultra-widefield FA diagnostic units available–the Spectralis Ultra-Widefield Angiography Module (Heidelberg Engineering), which provides 102-degree retinal images, and the Optomap fa (Optos), which provides 200-degree retinal images, according to Royce W. S. Chen, MD. In both cases, the viewing capabilities outstrip their conventional counterparts, which offer images ranging from 30 to 50 degrees of the retina.

    Ultra-widefield technology offers substantial advantages over conventional FA, Dr. Chen pointed out. Dr. Chen is the Helen L. and Martin S. Kimmel Clinical Assistant Professor of Ophthalmology, Columbia University Medical Center, New York.

    “Ultra-widefield FA can capture a larger area of the retina in one frame compared with standard FA,” Dr. Chen explained. “It is advantageous to be able to visualize both the posterior pole and the peripheral retina at the same moment in time.

     

    Figure 1. This ultra-widefield FA image shows diffuse capillary leakage, dark spots of hypofluorescence, and areas of complete capillary dropout in the periphery encroaching on the macula that led to the diagnosis of ischemic central retinal vein occlusion. (Images provided by Royce W. S. Chen, MD)

    “Previously, when several images had to be montaged together, there was a time difference between when the images were obtained,” he added. “In some patients who were more challenging to image with standard field FA, views of pathologies in the peripheral retina are now more easily obtainable.”

    Some cases presented

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