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Importance of Baseline Fluorescein Angiography for Patients Presenting to Tertiary Uveitis Clinic.
Karaca, Irmak; Bromeo, Albert; Ghoraba, Hashem; Lyu, Xun; Thng, Zheng Xian; Yasar, Cigdem; Akhavanrezayat, Amir; Yavari, Negin; Uludag Kirimli, Gunay; Than, Ngoc Tuong Trong; Shin, YongUn; Gupta, Ankur Sudhir; Khatri, Anadi; Mohammadi, S Saeed; Hung, Jia-Horung; Or, Christopher; Do, Diana V; Nguyen, Quan Dong.
Afiliação
  • Karaca I; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); John A. Moran Eye Center, University of Utah, Salt Lake City, Uhio
  • Bromeo A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Asian Eye Institute, Makati, Philippines (A.B.).
  • Ghoraba H; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Cole Eye Insttitute, Cleveland Clinic, Cleveland, Ohio, USA (H.G.)
  • Lyu X; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Duke University, School of Medicine, Durham, North Carolina, USA (
  • Thng ZX; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); National Healthcare Group Eye Institute, Tan Tock Seng Hospital, S
  • Yasar C; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Akhavanrezayat A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Yavari N; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Uludag Kirimli G; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Duke Eye Center, Durham, North Carolina, USA (G.U.K.).
  • Than NTT; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Shin Y; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Department of Ophthalmology College of Medicine, Hanyang Universit
  • Gupta AS; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Khatri A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.); Birat Eye Hospital, Biratnagar, Nepal (A.K.); Birat Medical Colleg
  • Mohammadi SS; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Hung JH; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Or C; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Do DV; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.).
  • Nguyen QD; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA (I.K., A.B., H.G., X.L., Z.X.T., C.Y., A.A., N.Y., G.U.K., N.T.T.T., Y.S., A.S.G., A.K., S.S.M., J.-H.H., C.O., D.V.D., Q.D.N.). Electronic address: ndquan@stanford.edu.
Am J Ophthalmol ; 265: 296-302, 2024 May 01.
Article em En | MEDLINE | ID: mdl-38701875
ABSTRACT

PURPOSE:

To ascertain whether the use of ultra-wide-field fluorescein angiography (UWFFA) at baseline visit alters the assessment of disease activity and localization, as well as the management of patients presenting to a tertiary uveitis clinic.

DESIGN:

Retrospective comparison of diagnostic approaches.

METHODS:

Baseline visits of 158 patients who presented to the Uveitis Clinic at the Byers Eye Institute at Stanford between 2017 and 2022 were evaluated by 3 uveitis-trained ophthalmologists (I.K., A.B., and H.G.). Each eye had undergone clinical examination along with ultra-wide-field fundus photography (UWFFP) (Optos Plc), spectral-domain optical coherence tomography (SD-OCT, Spectralis Heidelberg, Heidelberg Engineering) and UWFFA (Optos Plc) at the baseline visit. Investigators were asked to successively determine disease activity, localization of disease (anterior, posterior or both), and management decisions based on clinical examination and UWFFP and SD-OCT (Set 1) and Set 1 plus UWFFA (Set 2). The primary outcome was the percentage of eyes whose management changed based on the availability of UWFFA compared with Set 1.

RESULTS:

The mean age of the patients was 46.9 ± 22.4 years (range, 7-96), and 91 (57.6%) were female. With Set 1 alone, 138 eyes (55.2%) were found to have active disease; localization was anterior in 58 eyes (42.0%), posterior in 53 eyes (38.4%), and anterior + posterior in 27 eyes (19.6%). With Set 2, 169 eyes of 107 patients had active anterior, posterior, or panuveitis. In comparison with Set 1, assessment with Set 2 identified additional 31 eyes (18.3%) with active disease (P = .006) and an additional 31 eyes (18.3%) having disease in both anterior + posterior segments (P < .001). Regarding the primary outcome, management was changed in 68 eyes (27.4%) in Set 2 compared with Set 1.

CONCLUSIONS:

Baseline UWFFA may alter assessment of disease activity, localization, and management decisions compared with clinical examination with only UWFFP and SD-OCT for eyes with uveitis. Thus, UWFFA may be considered as an essential tool in the evaluation of patients with uveitis at the baseline visit.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article