This video illustrates a method for providing real-time fluorescein angiography (FA) during digitally assisted vitreoretinal surgery (DAVS). A 485-nm bandpass filter was placed in the accessory light sources of the Constellation machine with steel-modified washers to produce an exciter source, and a 535-nm bandpass filter in another steel washer was placed into the blank slot of an active laser filter to produce a barrier filter. A specific color channel was developed for DAVS using Ngenuity. Fluorescein, 500 mg in 5 mL, was then injected intravenously during retinal surgery and yielded consistent fluorescence patterns that were able to detect choroidal and retinal vascular flow, microvascular ischemia, neovascularization, shunt vessels, microaneurysms, and leakage into the vitreous. Angiography was visualized and recorded in 3D with 4k resolution. The presenters were able to identify areas of ischemia, which were treated more heavily with laser, as well as subtle leakage from neovascularization that permitted excellent hemostasis, among other valuable findings.

Financial Disclosures: Dr. Alan Franklin discloses relationships with Alcon Laboratories, Inc. (Consultant/Advisor, Grant Support); AclepiX (Consultant/Advisor); and ForwardVue Pharma (Owner of Company).

Dr. Christopher Riemann discloses relationships with Aerepio (Grant Support); Alcon Laboratories, Inc. (Consultant/Advisor, Lecture Fees/Speaker Bureau, Grant Support); Alimera Sciences, Inc. (Consultant/Advisor, Lecture Fees/Speaker Bureau); Allergan, Inc. (Lecture Fees/Speakers Bureau, Grant Support); Animal Foundation International (Consultant/Advisor); Aniridia Foundation International (Consultant/Advisor); Bausch + Lomb (Consultant/Advisor, Lecture Fees/Speaker Bureau); BioTime Inc. (Consultant/Advisor, Grant Support); Bryn Mawr Communications (Consultant/Advisor); Carl Zeiss Meditec (Consultant/Advisor); Clovernook Center for the Blind and Visually Impaired (Conultant/Advisor); CSTLII (Lecture Fees/Speaker Bureau); DORC International, by Duth Ophthalmic, USA (Consultant/Advisor) ForwardVue (Consultant/Advisor, Owner of Company, Equity Stock Holder - Private Company); Genentech (Grant Support); Haag Streit USA (Consultant/Advisor, Lecture Fees/Speaker Bureau); HumanOptics AG (Consultant/Advisor); IamC2 (Consultant/Advisor, Patents/Royalty); Johnson (Consultant/Advisor, Patents/Royalty); Kaleidoscope (Consultant/Advisor); MedOne Surgical, Inc. (Consultant/Advisor, Patents/Royalty); Notal Vision, Inc. (Consultant/Advisor); Novartis Pharma AG (Lecture Fees/Speakers Bureau); Orbit Biomedical (Consultant/Advisor); Regeneron Pharmaceuticals, Inc. (Grant Support); and Reliance Medical Products (Consultant/Advisor).

Drs. Lauren Gibson and Gustavo Huning disclose no financial relationships.