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Angiographs

Diagnosis and therapeutic orientation

L’angiographie rétinienne est un examen dynamique de diagnostic permettant de visualiser le système vasculaire de la rétine et de détecter des anomalies qui ne sont pas toujours visibles avec d’autres méthodes d’imagerie du fond d’œil.

Performed using a fluorescent contrast product (colour) injected into the patient’s blood circulation, it is therefore seen as invasive and requires a convenient equipment to perform the injection and the resuscitation in case of allergic reaction.

L’angiographie trouve son utilité pour le diagnostic et le suivi de pathologies vasculaires telles que la rétinopathie diabétique, la AMD, les uvéites postérieures…

Depending on the depth of the tissue to examine and on the pathology, two different contrast products can be used. So they define two types of angiography, the fluorescein one (FA) and the indocyanine green one (ICG).

Current angiographs, often equippedwith a confocal SLO laser system.The current angiographs, often equipped with an SLO confocal system, able to precisely focus on retina, make possible performing the fluorescein angiography only, the indocyanine green angiography only or sometimes both angiographies at the same time.

Our angiography solutions

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Mirante SLO (SLO)

Mirante is a large-field multimodal-imaging platform designed to perform fundus imaging. It combines OCT and SLO technologies thus grouping routine imaging to detect and identify retinal-choroidal pathologies.

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Mirante (SLO/OCT)

Mirante is a large-field multimodal-imaging platform designed to perform fundus imaging. It combines OCT and SLO technologies thus grouping routine imaging to detect and identify retinal-choroidal pathologies. Using an additional lens, performing an analysis of sections of the anterior segment is also possible.

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Techniques used

The injection angiography is the only examination making possible viewing fundus vascularisation in a dynamic way. It is then possible to analyse early, intermediate and late phases of retinal and choroidal blood circulations.

Angiography is often performed using an SLO angiograph, as this equipment can make a precise focus on retina. The purpose is detecting vascularisation anomalies, such as:

Aneurysms
Leaks
Oedemas
Ischemia
AMD
Diabetic retinopathy
Vascular occlusions and tumours, etc.

The examination is performed using a contrast product injected into the patient’s blood circulation.

During the examination, the angiograph illuminates the fundus with a specific wavelength to stimulate the colour to make it visible. Angiography images then only show the colour circulation into the vascular system, thus matching the blood behaviour into the vessels.

We use angiography to make a precise diagnosis, to propose an adapted treatment and to follow-up the evolution of the patient’s pathology through a control. When a complete analysis of the structure/function of the retina is required, the angiography is always used in addition to the OCT.

This imaging technique is different from the OCT-Angiography, which is non invasive, as it derives from the OCT (scanner of the retina). This last technique remains static and for the moment its acquisition field is limited.

Pathologies that can be detected using an angiograph

We can use the result to control the condition of the retinal and choroidal vascular system, affected in many eye pathologies:

Image courtesy: Dr Djaborouti (Puilboreau, France), hospital Luigi Sacco (University of Milan, Italy), hospital Lariboisière (Paris, France).

The different types of angiography

According to the pathology and the vascularisation to observe, you can use different contrast products. We know the fluorescein one and the indocyanine green one.

Fluorescein angiography (FA)

Fluorescein angiography is the most commonly used. It is particularly used before a session of laser photocoagulation. It is used to perform the analysis of the retinal vascularisation of surface layers. The examination takes only ten minutes.

Indocyanine green angiography (ICG)

The indocyanine green angiography is less used but it is the only method making possible viewing the vascularisation of deep layers including the choroidal layer. The examination is performed under infrared light and can last up to 30 minutes.

Benefits of angiography

The angiography is the only technique realising a dynamic observation of fundus vascularisation. Depending on the lens used, the analysis zone can be extended to make possible detecting some early vascular anomalies.

Dynamic analysis of retinal and choroidal vascularisation

Visualisation du fond d’œil jusqu’à l’extrême périphérie grâce au grand champ

The vascular analysis completes the structural analysis performed using fundus photography and the OCT to confirm and refine the diagnosis.

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