PMC4335623_01
Widefield FA prior to treatment.. Notes: Areas of nonperfusion are shaded blue, while areas of perfusion are orange. The ischemic index is 50.6%.. Abbreviation: FA, fluorescein angiography.
opth-9-337Fig1.jpg
PMC4335623_01_opth-9-337Fig1.jpg
f1-opth-9-337
Optos wide-field FA demonstrated a relationship between his optical coherence tomography (OCT) volume and ischemic index, which was 50.6% on initial presentation (Figure 1).
Widefield FA after initial targeted retinal photocoagulation.. Notes: Areas that have been lasered are shown in grey. The ischemic index is 40.9%.. Abbreviation: FA, fluorescein angiography.
opth-9-337Fig2.jpg
PMC4335623_01_opth-9-337Fig2.jpg
f2-opth-9-337
However 1 month after this guided peripheral TRP, the patient's vision was still 20/200 and his retinal volume had increased to 15.0 mm3, with recurrent rubeosis and an ischemic index of 40.9% (Figure 2).
Widefield FA 3 months later, following additional targeted retinal photocoagulation.. Note: The ischemic index is 38.7%.. Abbreviation: FA, fluorescein angiography.
opth-9-337Fig3.jpg
PMC4335623_01_opth-9-337Fig3.jpg
f3-opth-9-337
TRP was applied over multiple sessions over the next several months, extending more posteriorly into the areas of reversible ischemia (Figure 3). These additional treatments were done in a staged fashion in the hopes of treating the minimal amount of retina possible to achieve the desired goal of absence of recurrent rubeosis and edema.
Widefield FA after completion of targeted retinal photocoagulation.. Note: The ischemic index is 14.2%.. Abbreviation: FA, fluorescein angiography.
opth-9-337Fig4.jpg
PMC4335623_01_opth-9-337Fig4.jpg
f4-opth-9-337
TRP was given to most of the area of reversible ischemia (Figure 4) in addition to the previously lasered nonreversible ischemic zones. To ensure that the entire zone (reversible and nonreversible) of nonperfusion was included in the treatment plan, Optos widefield