OCCULT RETINAL AND CHOROIDAL VASCULAR-DISEASE - THE VALUE OF TIMED AND DIRECTED FLUORESCEIN ANGIOGRAPHY

Background. Acute vascular disease of the choroid or large vessels of the retina is usually accompanied by funduscopic signs. In instances o f monocular visual loss, such objective signs are important diagnostic clues that the pathology is in the eye and not in the optic nerve. Me thods: Fluorescein angiography was timed in a consistent manner, and p hotographs were taken at two frames per second. Orientation of the cam era was customized for each patient based on the location of the visua l field defect. Results: Eight patients with monocular visual loss wer e referred because the cause of the visual loss was not evident. In ea ch patient, fluorescein angiography showed vascular disease of either the choroid or retina, despite normal-appearing fundi. Conclusions: Fl uorescein angiography can detect otherwise occult vascular disease of the retina or choroid. In eyes with monocular scotomas, the angiogram should be performed with the camera oriented with respect to the locat ion of the visual field defect. Accurately timed, rapid sequence photo graphy provides additional information about rate and symmetry of flow . Focal areas of hypoperfusion often are incidental but deserve added consideration when they correspond to the location of a scotoma.