#19: Advances in Angiography: Ultra Widefield Angiography and OCT Angiography

May 18, 2016

Fluorescein angiography as a diagnostic tool is more than 60 years old, but recent advances in technology have refined and improved upon previously available imaging techniques to give eye care professionals a broader window into the retinal pigment epithelium.

OCT angiography* of patient with pseudoxanthoma elasticum with concomitant geographic atrophy (GA) and choroidal neovascularization (* SPECTRALIS OCT Angiography Module is under development and not for sale yet).Fluorescein angiography as a diagnostic tool is more than 60 years old, but recent advances in technology have refined and improved upon previously available imaging techniques to give eye care professionals a broader window into the retinal pigment epithelium.

Noncontact ultra-widefield (UWF) fluorescein angiography provides clinicians with larger than a 100 degree field of view in a single shot compared to the 30 to 50 degree view offered by traditional fluorescein angiography. Compared to traditional fluorescein angiography, use of noncontact UWF imaging allows for a significantly improved ability to capture the posterior pole as well as peripheral retinal pathology in a single, nonsteered shot.

Diabetic retinopathy as seen with Ultra Widefield Angiography Module for SPECTRALIS(R).

UWF angiography has been shown to be valuable for the evaluation of several retinal pathologies, including diabetes, retinal vein occlusions, choroidal masses, and uveitis, among others.

Optical coherence tomography angiography (OCT-A), meanwhile, has more recently emerged as a potential supplement to fluorescein-based angiography for certain conditions. OCT-A is a non-invasive imaging technique that employs motion contrast imaging to quickly generate angiographic images.

Although OCT-A is still a relatively novel technique that has not been frequently used in standard clinical practice yet, it has been shown in clinical trials to provide volumetric data with the clinical capability of specifically localizing and delineating pathology. OCT-A is thought to be useful in the evaluation and monitoring of conditions such as age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma.