Year : 1983 | Volume
: 31 | Issue : 7 | Page : 1064--1067
Fluoresceine angiography in myopic degeneration
Shashank M Patel, BM Khamar, UM Vyas, BS Patel, RN Mathur
M & JInstitute of Ophthalmology, Ahmedabad, India
Shashank M Patel
M & J Institute of Ophthalmology, Ahmedabad 380 016
|How to cite this article:|
Patel SM, Khamar B M, Vyas U M, Patel B S, Mathur R N. Fluoresceine angiography in myopic degeneration.Indian J Ophthalmol 1983;31:1064-1067
|How to cite this URL:|
Patel SM, Khamar B M, Vyas U M, Patel B S, Mathur R N. Fluoresceine angiography in myopic degeneration. Indian J Ophthalmol [serial online] 1983 [cited 2021 Jun 20 ];31:1064-1067
Available from: https://www.ijo.in/text.asp?1983/31/7/1064/29748
In this paper an attempt is made to corelate various myopic degenerative conditions with angiography.
MATERIAL AND METHODS
Fluoresceine angiography was performed in various persons with different types of myopic degenerations and fluoresceine findings are co-related with various degenerations.
Myopic degenerations commonly seen are of following nature.
1. Myopic crescent
2. Tesselated Background.
3. Posterior staphyloma.
4. Chorioretinal atrophy.
5. Subretinal neovascularizauon
6. Fuch's spot.
7. Disciform degeneration of macula. 8. Retinal pigment epithelial defect.
In myopic crescent usually only sclera is visible so fluoresceine angiogram does not show any fluroresceine in this area in early phase in later phase there is scleral staining [Figure 1].
When choroid extends more than retina, -horoid is visible as areas of hyperfluoures;entin the early phase and persist through all phases. This may give rise to neovascularization. [Figure 2] serous detachment of central retina.
Sometimes choroidal vessels are seen traversing through the crescent. This is unlike previous conditions where you find rim of choroid. Peculiarity of these vessels was found not to leak dye, (Fi)z. 3)
Fuch's spot is elevated, circular dark or red spot at macula. On fluoresceine angiogram this shows sub-retinal neovascularization, and become hyperfluorescent [Figure 4][Figure 5]
On ophthalmoscopic examination SRNVM seen as a red spot, or choroidal haemorrhage or elevated greyish white membrane. SRNVM is arising from choroidal vessels. This area become hyperfluorescent which increses with passage of time and dye leaks into surrounding area. SRNVM may be present at the margin [Figure 6][Figure 7] or in the chorio-retinal atrophic patch [Figure 8][Figure 9] or in posterior staphyloma.
Chorioretinal atrophy:- Chorio-retinal atrophy looks like irregular white area, with pigmentation. Pigments may be in the centre or at the periphery of the atrophic patch. On fluoresceine angiography this area remains hypofluorescent, due to abscence of chorioopillaries in this area. Medium sized and large choroidal vessels traversing through this area are clearly visible. [Figure 7][Figure 9] In later phases this area becomes hyperfluorescent due to scleral staining perticularly at the margin.
Retinal Pigment Epithelial defect (RPE):
Small RPE defect is not make out on ophthalmoscopic examination. On Fl. angiogram small RPE defect visualized as a hyperfluorescent area, which does not increase in size [Figure 1]
Ophthalmoscopically this is seen as sudden kinking of the retinal vessels as they dip over its edges in the same way as they dip into a glaucomatous cup. On fl. angiogram shows area without RPE & chorio-capillarres, choroidal vessels are seen in this area. Retinal vessels are seen as bending at the margin.
Tesselated background as seen Ophthalmoscopically is believed to be due to lack of pigments in RPE. This allows visualization of blood vessels of the choroid.
Surpirisingly it was not evident in (16) few cases on fluoresceine angiography though seen by Ophthalmoscope. We believe this to because of higher density of pigments in pigmented people which blocks choroidal fluoresceine even when minimal. This was seen in patients below the age of 32 years & below -12.0 D refractive error. except in two cases with -18.0 D & -22.0 D.
It was seen in all cases above the age of 32 and in refractive errors more than -12.0D. thus tesselation seen with Fl angio. can be correlated to age and power a1 myopia suggesting this is an on going degenerative nature.