Dr. Kumar K S, K08476
Aim:
To present a compilation of FFA findings in diverse conditions. Unique feature ; this paper will have no results but only observations not visible on clinical examination but only on FFA in a series of interesting & rare clinical entities highlighting dynamics of retinal blood flow alterations .
Material and methods:
A case wise discussion of interesting FFA phenomena will be presented.
Case:1-Back and forth blood flow in the cilioretinal artery (CiRA) in CRVO.
Pathophysiology:-CiRA (pressure of about 40 mmhg) is pumping against an increased pressure head ( 60mmhg) in the retinal veins (in CRVO) into which it drains. Intraluminal pressure fluctuations related to the respiratory and cardiac cycles induces the back and forth blood flow pattern seen within the CiRA
Case:2-Migraine caught in the act!
Retinal vasospasm in a young patient causing slow flow in the retinal circulation with visibility of the leading edge of fluorescein dye in the retinalarterioles. This resolved on cessation of the attack of migrainewith restoration of normal retinal blood flow
Case:3-Nasal CSR : a young woman was incidentally noted to have serous RD nasal to the disc that on FFA was seen to be CSR related . Rare occurence of nasal CSR is documented
Case 4: A CNVM occuring at the site a resolved retinal macroaneurysm that is rare is shown in this case. It resolved with intravitreal avastin.
Case 5: Acute retrograde blood flow in the cilioretinal artery in a case of presumed viral optic neuritis that normalised 4 days later will be presented.
Case 6: FFA features typical of diabetic papillopathy showing radial telengiectatic disc vessels as opposed to NVD /AION is demonstrated in this FFA
Case 7: FFA that was needed in a diabetic myopic patient with nephropathy showed early NVE & areas of capillary drop outs implying that myopia is not an insurance against development of severe changes of diabetic retinopathy
Case 8: a case of suspected IRVAN with well seen acquired retinal macroaneurysms is shown.
Conclusions: Proper techniques in performing FFA and its timing helps in picking up, analysing and interpreting these fine prints on FFA. Interesting & instructive vascular phenomena in various retinal diseases can be spotted
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