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Measuring the precise area of peripheral retinal non-perfusion using ultra-widefield imaging and its correlation with the ischaemic index

Br J Ophthalmol. 2016 Feb;100(2):235-9. doi: 10.1136/bjophthalmol-2015-306652. Epub 2015 Jul 1.

Abstract

Objective: To determine the calculated, anatomically correct, area of retinal non-perfusion and total area of visible retina on ultra-widefield fluorescein angiography (UWF FA) in retinal vein occlusion (RVO) and to compare the corrected measures of non-perfusion with the ischaemic index.

Methods: Uncorrected UWF FA images from 32 patients with RVO were graded manually for capillary non-perfusion, which was calculated as a percentage of the total visible retina (uncorrected ischaemic index). The annotated images were converted using novel stereographic projection software to calculate precise areas of non-perfusion in mm(2), which was compared as a percentage of the total area of visible retina ('corrected non-perfusion percentage') with the ischaemic index.

Results: The precise areas of peripheral non-perfusion ranged from 0 mm(2) to 365.4 mm(2) (mean 95.1 mm(2)), while the mean total visible retinal area was 697.0 mm(2). The mean corrected non-perfusion percentage was similar to the uncorrected ischaemic index (13.5% vs 14.8%, p=0.239). The corrected non-perfusion percentage correlated with uncorrected ischaemic index (R=0.978, p<0.001), but the difference in non-perfusion percentage between corrected and uncorrected metrics was as high as 14.8%.

Conclusions: Using stereographic projection software, lesion areas on UWF images can be calculated in anatomically correct physical units (mm(2)). Eyes with RVO show large areas of peripheral retinal non-perfusion.

Keywords: Imaging; Retina.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Capillaries / pathology
  • Female
  • Fluorescein Angiography*
  • Humans
  • Image Processing, Computer-Assisted
  • Ischemia / classification
  • Ischemia / diagnosis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Retinal Vein Occlusion / classification
  • Retinal Vein Occlusion / diagnosis*
  • Retinal Vessels / pathology*