Weitwinkel-Angiographie-Bildgebung zur Detektion von Ischämien bei Retinalen Venenverschlüssen
von Sophie Elisabeth Peter
Datum der mündl. Prüfung:2024-03-05
Erschienen:2024-02-21
Betreuer:Prof. Dr. Nicolas Feltgen
Gutachter:Prof. Dr. Nicolas Feltgen
Gutachter:PD Dr. Bawarjan Schatlo
Dateien
Name:SUB_Dissertation_S.Peter.pdf
Size:31.1Mb
Format:PDF
Zusammenfassung
Englisch
Retinal vein occlusions (RVO) are a relatively common and clinically relevant ophthalmological condition with numerous potential complications. Since diagnosis using fluorescein angiography (FAG) imaging, particularly the classification into prognostically favorable and unfavorable courses, is highly subjective and unreliable in clinical practice, this retrospective study aimed to investigate how FAG diagnostics could be improved or simplified. Additionally, it sought to determine the extent to which imaging parameters could provide insights into the clinic and prognosis of the patient. To achieve this, two previously adapted or standardized methods for analyzing FAG images in RVO were compared in terms of their reliability and reproducibility. Both analysis methods showed significant differences between various evaluators, primarily indicating poor reproducibility. Greater disparities were observed with the sector method, with the freehand drawing method proving slightly more reliable. While ischemia could be easily recognized even by a novice, determining the exact extent of the ischemic area appeared to be more challenging even for experienced physicians. Furthermore, it became evident that both poor image quality and additional changes such as bleeding, vitreous opacities, or macular degeneration, regardless of the method used, complicated image analysis. In the evaluation of clinical data, it was found that poor visual acuity was primarily associated with central ischemia rather than increased central retinal thickness indicative of macular edema. Both the size and location (central or peripheral) of the ischemic area correlated with visual acuity and retinal thickness, with patients affected by a retinal vein occlusion with extensive central ischemia exhibiting pronounced clinical symptoms and a worse prognosis.
Keywords: retinal vein occlusion; fluorescein angiography
Schlagwörter: Retinaler Venenverschluss; Fluoreszein- Angiographie; Netzhautischämie; Netzhautödem