Description

Fluorescein Angiography is an advanced diagnostic imaging procedure used in ophthalmology to assess the circulation of the retina and choroid. By injecting sodium fluorescein dye intravenously, it enables detailed visualization of the eye's blood vessels through a series of photographs. This process is crucial for identifying and characterizing various vascular abnormalities and pathologies.

Procedure Overview

• Dye Injection: The procedure begins with the intravenous injection of sodium fluorescein dye, typically a 10% solution.
• Imaging Equipment: Specialized cameras equipped with specific filters capture images of the fundus, the back of the eye.
• Imaging Phases: The imaging occurs in several phases, including choroidal, arterial, arteriovenous, and venous phases, documenting the dye's transit through the eye's blood vessels.

Preparation and Duration

• Preparation: Patients may need to fast, and pupil dilation is often required. Informed consent and allergy history review are essential steps.
• Duration: The procedure typically lasts between 5 to 30 minutes.

Clinical Indications

Fluorescein Angiography is commonly used for:

• Evaluating unexplained vision loss
• Managing diabetic retinopathy
• Detecting retinal vein and artery occlusions
• Identifying choroidal neovascular membranes
• Diagnosing conditions like age-related macular degeneration and hypertensive retinopathy

Diagnostic Insights

The procedure provides valuable insights through patterns of hyperfluorescence and hypofluorescence, revealing:

• Vascular leakage
• Nonperfusion areas
• Neovascularization

Contraindications and Complications

• Contraindications: Includes pregnancy, breastfeeding, and a history of severe allergic reactions to fluorescein.
• Common Side Effects: Nausea, vomiting, and temporary skin discoloration.
• Rare Complications: Severe allergic reactions and, in very rare cases, cardiac events.

Patient Aftercare

Patients are advised to arrange transportation due to potential temporary vision changes and to be aware of urine discoloration for up to 36 hours post-procedure. Monitoring for adverse reactions is recommended during and after the procedure.

Technical Considerations

High-quality imaging equipment and proper technique are vital for successful outcomes. Digital systems enhance image processing and storage, while emergency equipment should be readily available due to the risk of anaphylaxis.

Special Considerations

The procedure can be adapted for specific imaging needs, such as anterior segment imaging, and is generally safe for patients with heart conditions. Fluorescein Angiography remains a pivotal tool in the comprehensive management of retinal and choroidal diseases, providing essential information for effective diagnosis and treatment planning.