Wide-field angiography for diagnosis and follow-up of Eales disease: a case series / Angiografia de amplo campo para diagnóstico e monitoramento da doença de Eales: série de casos

ABSTRACT Wide-field angiography enables assessing peripheral areas with better quality and gives greater deep focus, which improves the image periphery. Some studies have proposed the usefulness of these angiographic systems in inflammatory diseases of the retina. However, few studies have evaluated this technique in Eales disease. We present a case series in which 5 eyes of 3 patients with Eales disease were evaluated by using retinal fluorescein angiography with 30º, 50º, and 150º lenses in a laser-scanning ophthalmoscope. These cases highlight the usefulness of wide-field fluorescein angiography in the diagnosis and follow-up of peripheral ischemic retinal areas in Eales disease, which enables better follow-up than possible with conventional fluorescein angiography images.

RESUMO A angiografia de campo amplo permite avaliar áreas periféricas com melhor qualidade e proporciona maior foco profundo, melhorando a imagem da periferia. Alguns estudos têm proposto a utilidade desses sistemas angiográficos nas doenças inflamatórias da retina. No entanto, poucos estudos avaliaram esta técnica na doença de Eales. Apresentamos uma série de casos em que 5 olhos de 3 pacientes com doença de Eales foram avaliados usando angiografia de fluoresceína da retina com lentes de 30º, 50º e 150º em um oftalmoscópio de varredura a laser. Esses casos destacam a utilidade da angiografia com fluoresceína de campo amplo no diagnóstico e no acompanhamento das áreas isquêmicas periféricas da retina na doença de Eales, permitindo um melhor acompanhamento do o possível com imagens por angiofluoresceinografia convencional.

Wide-field angiography for diagnosis and follow-up of Eales disease: a case series.

Wide-field angiography enables assessing peripheral areas with better quality and gives greater deep focus, which improves the image periphery. Some studies have proposed the usefulness of these angiographic systems in inflammatory diseases of the retina. However, few studies have evaluated this technique in Eales disease. We present a case series in which 5 eyes of 3 patients with Eales disease were evaluated by using retinal fluorescein angiography with 30º, 50º, and 150º lenses in a laser-scanning ophthalmoscope. These cases highlight the usefulness of wide-field fluorescein angiography in the diagnosis and follow-up of peripheral ischemic retinal areas in Eales disease, which enables better follow-up than possible with conventional fluorescein angiography images.

Imágenes de la coroides por tomografía de coherencia óptica en sujetos sanos y con enfermedades coriorretinales / Images of choroid by optical coherence tomography in healthy subjects and chorioretinal diseases

Objetivos: Describir las imágenes de la coroides por tomografía de coherencia óptica (TCO) de dominio espectral en sujetos sanos y con enfermedades coriorretinales. Materiales y métodos: Estudio de serie de casos. Se evaluaron 67 casos que incluyeron sujetos sanos oculares y pacientes con enfermedades coriorretinales. Las tomografías realizadas incluyeron un barrido de la retina y coroides a nivel de la mácula de manera convencional y otro usando el protocolo de profundidad de imagen mejorada (PIM). El espesor coroideo se midió desde el borde exterior del epitelio pigmentario de la retina hasta el reborde escleral interno. Resultados: De los 67 casos, 12 (17.4%) fueron sujetos sanos oculares, 10 (14,5%) con coriorretinopatía serosa central (CSC), 23 (33,4%) degeneración macular relacionada con la edad (DMRE), 9 (13,0%) miopía magna. 13 (18.8%) vasculopatía polipoidal coroidea. Existen diferencias en la calidad de las imágenes con TCO convencional y las realizadas con PIM, permitiendo describir solo coriocapilaris en algunos casos mientras que con el protocolo PIM se puede apreciar el grosor total coroideo. La coroides es de mayor espesor en la vasculopatía polipoidal coroidea (353,92 ± 68,66 µm) y en la CSC (408,81 ± 95,56 µm) que en los sujetos sanos (251,97 ± 66.37 µm) (p<0,05) y está disminuida en DMRE forma seca (124.69 ± 34.02 µm) (p<0,05), al igual que en la miopía magna (118.47 ± 34.02 µm) (p<0,05). Conclusiones: Las imágenes de TCO de la coroides por PIM es una técnica reproducible que permite describir y medir su espesor, estando disminuida en la DMRE, y miopía magna; e incrementada en vasculopatía polipoidal y la CSC.

Objectives: Describe the images of the choroid by optical coherence tomography (OCT) spectral domain in healthy subjects and chorioretinal diseases. Materials and methods: Case series study. We evaluated 67 cases involving healthy ocular subjects and patients with chorioretinal diseases. The scans included a sweep of the retina and choroid at level of the macula conventionally, and other using enhanced depth imaging (EDI). The choroid thickness was measured from the outer edge of the retinal pigment epithelium to the internal scleral rim. Results: Of the 67 cases, 12 (17.4%) were healthy ocular subjects, 10 (14.5%) with central serous chorioretinopathy (CSC), 23 (33.4%) agerelated macular degeneration (AMD), 9 (13.0%) with myopia, 13 (18.8%) with polypoidal choroidal vasculopathy. There are differences in the quality of images with conventional OCT and those with EDI, allowing only to describe the choriocapillaris in some cases while the EDI protocol can appreciate the total thickness of the choroid. The choroid is thicker in polypoidal choroidal vasculopathy (353.92 ± 68.66 microns) and CSC (408.81 ± 95.56 microns) than in healthy subjects (251.97 ± 66.37 mm) (p<0.05) and is decreased in the dry AMD (124.69 ± 34.02 microns) (p<0.05), as well as in the myopia (118.47 ± 34.02 microns) (p<0.05). Conclusions: OCT images of the choroid by PIM is a reproducible technique for describing and measuring its thickness, being decreased in AMD and myopia, and was increased in the polypoidal vasculopathy and CSC.