IVFA, OCTA, ICG

motion

OCTA is ______ based

blood flow

IVFA is ______ based

yes

is OCTA susceptible to motion artifacts?

no

is IVFA susceptible to motion artificats?

OCTA

which has better detail of capillary beds, OCTA or IVFA?

IVFA

which is considered invasive, OCTA or IVFA?

does not, is not

OCTA ______ (does/does not) show leakage but ____ (is/is not) obscured by leakage

does, is

IVFA ______ (does/does not) show leakage but ____ (is/is not) obscured by leakage

limited

OCTA has a _______ FOV

wide

IVFA has a ______ FOV

OCTA

imaging technique based upon the motion of RBCs & reflected light; maps the vascular tree in great detail: superficial capillary plexus, deep capillary plexus, avascular zone, choriocapillaris

high, small

OCTA has ______ (high/low) detail but a ______ (large/small) FOV

diabetes, coats, vein occlusions, macular telangiectasia, sickle cell, HTN

what diseases is OCTA good for imaging in the inner retina?

AMD, CSCR, CNVM, dystrophies that can develop CNV

what diseases is OCTA good for imaging in the outer retina?

glaucoma, neovascularization of the disc, NAION

what diseases is OCTA good for imaging at the ONH?

no

does IRMA leak on IVFA?

does not, all intraretinal

IRMA _____ (does/does not) breach the ILM, so flow overlay is located ________

does, extending into vitreous

proliferative neovascularization _____ (does/does not) breach the ILM, so flow overlay is located ________

yes

does proliferative neovascularization leak on IVFA?

right angle venules

what is the hallmark finding of macular telangiectasia type 2 on OCTA?

1. projection of vessels into deeper layers

2. motion due to blink or eye movement

3. media opacities casting shadows

4. shadowing due to reduced signal from blockage by overlying entity

what are the different types of OCTA artifcats?

inert

fluorescein dye is _________ (doesn’t react w/ anything in the body)

blue, 520-530

fluorescein absorbs wavelengths in the _____ range & fluoresces at ______nm

CNS

when injected intravenously, fluorescein dye leaks from all vessels except for those in the ______

30

when injecting fluorescein, enter the vein at about a ____ degree angle

nausea

injecting fluorescein too quickly can cause ______

poor early pictures

injecting fluorescein too early can cause __________

known allergy to the dye, pregnancy, lactation

what are the contraindications of IVFA?

1. allergic rxn (hives)

2. yellowing of skin & urine

3. nausea/vomiting

4. extravasation → tissue necrosis

what are the SE of IVFA?

no

do normal retinal vessels leak the fluorescein dye in IVFA?

1. choroidal flush

2. arterial phase

3. arteriovenous phase

4. venous phase

5. late venous phase

6. recirculation phase

7. late phase

list the phases of IVFA

choroidal flush

IVFA phase: choroid takes on a patchy, flushed appearance as dye enters the eye, this is blocked in the macula due to increased pigment

arterial phase

IVFA phase: dye rapidly fills the retinal arteries, over in a few seconds

arteriovenous phase

IVFA phase: after the retinal arteries fill, veins begin to fill, laminar flow, lasts until lumen fills entirely & typically covers only 5-10sec

laminar flow

initial filling along the walls of the veins seen in the arteriovenous phase of IVFA

venous phase

IVFA phase: arteries & veins are of equal intensity

late venous phase

IVFA phase: intensity in the veins is greater than that in the arteries

recirculation phase

IVFA phase: fluorescence progressively lessens as the dye leaves the system

late phase

IVFA phase: occurs 5-10min after injections, arteries & veins are essentially void of dye & the choroidal flush is minimal

30

w/in ____min of injection, all fluorescein dye will be gone from the eye

systemic vascular abnormality or occlusion

increased vein to eye filling time can be indicative of __________

filling defect, blockage

what 2 things can cause hypofluorescence on IVFA?

loss of normal blockage of background flush, leakage from abnormal vessels

what 2 things can cause hyperfluorescence on IVFA?

yes

is staining with the borders of the ONH & sclera normal on IVFA?

yes

do druse stain on IVFA?

indocyanine green

water-soluble dye that leaks less freely from choroidal vasculature than fluorescein

choroidal

what type of pathology is ICG preferred for?

longer

ICG takes _______ than IVFA

10min, 25min

with ICG, the mid phase is about _____ after injection & the late phase is about _____ after injection

pregnancy/lactation, known allergy, allergy to iodine or shellfish

what are the contraindications of ICG?

choroidal flush

arterial phase

arteriovenous phase

late phase

arteriovenous phase