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Purpose: To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow.
Design: Retrospective, observational case series.
Participants: Eyes presenting with fernlike patterns of dye leakage on UWFA were included in this study.
Methods: Analysis of the clinical characteristics and multimodal imaging findings using UWFA and wide-angle swept-source OCT-angiography (SS-OCTA).
Main Outcome Measures: The disease spectrum, anatomic origin, and clinical implications of this fernlike leakage.
Results: Multimodal retinal images from 40 eyes of 29 patients with fernlike leakage on UWFA were studied. The underlying etiologies included a wide range of inflammatory disorders, including pars planitis (18 eyes) and central retinal vein occlusion (2 eyes). On UWFA, the fernlike leakage originated from the retinal capillaries and venules directly adjacent to the veins and spared the periarterial zone. This perivenular fernlike leakage involved the far periphery in all cases and progressed more diffusely and centripetally in cases with more severe intraocular inflammation. On wide-angle SS-OCTA, the impairment of deep capillary plexus (DCP) flow signals precisely colocalized with the perivenular fernlike leakages identified on UWFA.
Conclusions: The fernlike leakage on UWFA refers to the distinctive perivenular dye leakage that originates from the retinal capillaries and venules. Multimodal imaging correlation suggests that the predominant impairment is at the level of the DCP. The axial symmetry of the fernlike leakage with the veins and sparing of the periarterial zone may support the dominant venous role of the DCP.
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http://dx.doi.org/10.1016/j.oret.2022.05.001 | DOI Listing |
Infection
June 2025
Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, 783-8505, Kochi, Japan.
Am J Ophthalmol
September 2025
From the School of Medicine (M.C., C.B., L.B., F.B., E.M.), Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology (M.C., C.B., L.B., F.B., E.M.), IRCCS San Raffaele Scientific Institute, Milan, Italy.
Purpose: To investigate peripheral vascular changes and their progression in intermediate uveitis characterized by a fern-like leakage pattern and examine their relationship with macular vascular changes to elucidate their pathogenesis, natural history, and clinical implications.
Design: Retrospective, observational case series with healthy-eyes comparison.
Participants: 43 eyes (28 patients) with intermediate uveitis (mean age 31±16 years, 58% female) followed for an average of 18 months, compared with 41 healthy control eyes.
Rom J Ophthalmol
May 2025
Department of Ophthalmology, Command Hospital (Eastern Command), Kolkata, India.
Objective: To investigate the occurrence and characteristics of the "Fern-like pattern" (FLP) on ultra-wide field fluorescein angiography (UWFA) across a variety of uveitic conditions, challenging the traditional association of FLP primarily with Behçet's disease (BD).
Methods: This observational study at a tertiary care centre in India analysed the UWFA images of 23 eyes from 12 patients diagnosed with BD, tubercular vasculitis, intermediate uveitis, Vogt‒Koyanagi‒Harada (VKH) syndrome, or exudative retinal detachment. Clinical and imaging data were reviewed to assess the presence and implications of FLP in these conditions.
Sci Rep
March 2024
Institute of Biochemistry and Biophysics, University of Tehran, Tehran, 1417614335, Iran.
In pulmonary inflammation diseases, like COVID-19, lung involvement and inflammation determine the treatment regime. Respiratory inflammation is typically arisen due to the cytokine storm and the leakage of the vessels for immune cells recruitment. Currently, such a situation is detected by the clinical judgment of a specialist or precisely by a chest CT scan.
View Article and Find Full Text PDFOphthalmol Retina
November 2022
Stein Eye Institute, University of California Los Angeles, Los Angeles, California. Electronic address:
Purpose: To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow.
Design: Retrospective, observational case series.
Participants: Eyes presenting with fernlike patterns of dye leakage on UWFA were included in this study.