PEDIATRIC RETINAL IMAGING FEATURE STORY JULY/AUGUST 2011 I RETINA TODAY I 79 D iagnostic imaging has rapidly progressed over the past decade, particularly in regard to the ability to analyze the macula with optical coherence tomography. In contrast, the reti- nal periphery has proved more difficult to image, and, therefore, it is more difficult to understand the patholo- gies that affect the periphery. Recent advances in wide- field imaging allow more detailed views of the retinal periphery, which is particularly beneficial in pediatric retina pathologies, such as retinopathy of prematurity (ROP), Coats disease, and familial exudative vitreo- retinopathy (FEVR). Widefield fluorescein angiography (WFFA) is quickly becoming essential not only for diag- nosis and management, but to further our understand- ing of pediatric retinal disease. The Optos 200 Dx (Optos PLC, Dunfermline, United Kingdom) scanning laser ophthalmoscope obtains a 200º wide-range field in a single image. Although the Optos 200 is a good option for adults and children capable of positioning upright, it does not work well for infants. Therefore, the Bascom Palmer Eye Institute in Miami been utilizing the Retcam II (Clarity Medical Widefield Fluorescein Angiography in Pediatric Retinal Diseases: The Next Frontier BY ANDRES EMANUELLI, MD; GEETA A. LALWANI, MD; THOMAS SHANE, MD; TIMOTHY G. MURRAY, MD, MBA; AND AUDINA M. BERROCAL, MD Figure 1. Female patient aged 7 years with Coats disease showing significant lipid exudation with dilated capillaries. Montage photos allow documentation of the peripheral pathology of this disorder. Figure 2. Fluorescein angiography (FA) on the same patient with Coats disease. Note the dilated capillaries and the charac- teristic zone of ischemia peripheral to these vascular changes.