Gisung Son, Suchan Lee, Hee Young Jung, Kyung Min Lee, Young Sook Park, Joonhong Sohn and Duck Jin Hwang
Objectives: To investigate patients with Proliferative Diabetic Retinopathy (PDR) using ultra-wide field fluorescein angiography (UWFA) images and to compare the detection rate of PDR progression using conventional seven standard field angiography (7SF) images. Methods: One hundred and one eyes of 67 patients with PDR who underwent fluorescein angiography using the Optos Optomap Panoramic 200A imaging system were included. Three hundred three images of 101 eyes at different time points (initial, Post-Panretinal Photocoagulation [PRP], and follow-up) were evaluated. In comparing 101 follow-up with 101 post-PRP images, we found newly developed Neovascularization (NNV) and newly developed non-perfusion (NNP) areas, which were then analyzed using two different methodologies: UWFA and 7SF. NNVs were counted while NNP area was measured in pixels using ImageJ software. Results: UWFA detected 21 eyes with NNV, which was approximately twice the number of eyes detected using 7SF (11 eyes). Ten eyes presented with NNV outside the 7SF area with apparently clean 7SF without NNV. UWFA detected 25 eyes with NNP areas, which was more than the six eyes detected using 7SF (19 eyes). Six eyes presented with NNP areas outside the 7SF, which were apparently fully perfused by 7SF. In addition, UWFA detected 2.59 times more NNP area than that by 7SF. Conclusion: Compared with conventional 7SF imaging, UWFA shows significantly improved retinal visualization and improves progression detection rates in patients with PDR.