Angiografia Fluoresceínica na Retinopatia da Prematuridade: um ano de experiência

Objective: To assess the role of fluorescein angiography (FA) in the diagnosis and follow-up of premature infants with Retinopathy of Prematurity (ROP) with need for treatment (severe ROP).   Materials and methods: Retrospective analysis of color fundus photographs and FA images captured with RetCam from prematures with severe ROP studied with these diagnostic modalities at our hospital between August 2018 and August 2019.   Results: FA was performed in 26 eyes of 13 preterm infants with severe ROP. In 7 infants (54%), angiography was performed at the day of treatment (laser photocoagulation: n=12; bevacizumab injection: n=1). FA showed profound retinal vascular changes especially at the vascular-avascular junction, with remarkable exudation from neovascularization areas. In the remaining children (46%), angiography was performed during follow-up period (ages 6 months to 9 years-old) after laser photocoagulation (n=5), vitrectomy+laser (n=1) or bevacizumab injection (n=6). Among the eyes treated with intravitreal injection, 2 developed recurrent disease, also evidenced by peripheral exudation on FA, and consequently underwent LASER avascular retinal ablation; the remaining eyes did not show recurrence of the disease but revealed extensive areas of avascular peripheral retina on FA. Overall, FA showed a wide variety in retinal circulation and choroidal filling patterns, the most frequent findings being anomalous branching at the level of small arterioles (100%) and arteriovenous shunts (69%).   Conclusion: FA allowed better characterization and documentation of vascular anomalies found in ROP in this case series, although it did not contribute decisively to the therapeutic decision.   Keywords: Retinopathy of Prematurity, angiography, RetCam, laser photocoagulation, anti-VEGF