Quantifying Areas of Vascular Leakage in Sickle Cell Retinopathy Using Standard and Widefield Fluorescein Angiography

BACKGROUND AND OBJECTIVE: To evaluate neovascular surface area change in sickle cell retinopathy following scatter photocoagulation treatment in wide- and standard-field fluorescein angiography (FA) scans using ImageJ software. PATIENTS AND METHODS: Images of 11 patients with wide- or standard-field FA scans pre- and post-treatment for sickle cell retinopathy were evaluated retrospectively by two graders using ImageJ. Graders traced lesions in the late arteriovenous phase and calculated the lesion area and intensity relative to the optic disc. Changes in area and intensity pre- to post-treatment were assessed using dependent t-tests. RESULTS: Pre- to post-treatment, lesion area decreased by 3.34 +/- 2.43 to 3.66 +/- 3.72 disc areas (P \u3c .001), whereas intensity decreased by 11.36 +/- 25.87 to 22.97 +/- 69.25 units (P = .104). Neovascular area declined status post-aphotocoagulation by 3.83 +/- 3.65 disc areas (P = .003) for widefield images and by 2.81 +/- 3.55 discs areas (P = .034) for standard fluorescein images. No statistical difference in area reduction was appreciated between imaging modalities (P = .652). CONCLUSION: Neovascular area decreased significantly following scatter photocoagulation in both standard-field and widefield FA scans without an appreciable difference between imaging modalities