Fluorescein angiogram

What is fluoresceine angiography?

This examination consists of photographing the fundus of the eye (i.e. the retina and the optic nerve at the back of the eye) after injecting a fluorescent dye in an artery, usually in the fold of the elbow (as for a blood test).
In just seconds, the dye travels to the blood vessels inside the eye. A camera equipped with special filters that highlight the dye is used to photograph the path of the fluorescein as it circulates though the eye. In many cases, these photos are taken with a digital camera system, allowing the physician to interpret the results immediately.
This is an efficient way of assessing the condition of the fundus, more specifically its blood vessels and especially the retina.

Angiography is indicated:

• To diagnose particular eye diseases, especially of the retina and optic nerve.
• To establish whether the disease can be treated, for example by laser photocoagulation.

Fluo-angiography is most frequently used in dealing with diabetic retinopathy and macular degeneration.

 

How does the examination take place?

This examination is ambulatory, no hospitalization is required. The pupils have to be dilated. Consequently it is recommended that the patient be accompanied after examination or that public transport be used, as driving after the examination is dangerous. Pictures of the fundus of the eye are taken at high speed for at least 5 to 10 minutes. Patients are advised to remain in the waiting room for half an hour after the examination.

In most cases the examination is well tolerated. Before carrying it out, your ophthalmologist will ask for supplementary details regarding possible allergies and/or respiratory and skin reactions to medication or food or resulting from anaesthesia.

Side effects

Side effects which may occur but are not serious are:

• Skin and urine will be coloured yellow for some time following the injection of fluoresceine.
• The injection is painless, except when the fluid is injected alongside the artery, but this has no serious consequences.
• Following the injection, nausea may occur. If the patient has already experienced this, please notify the ophthalmologist. Medication given before the examination can prevent nausea and enhance comfort without interrupting the examination.
• Should the patient feel uncomfortable the best remedy is to lie down for a while.

Serious side effects may appear unexpectedly but fortunately are very rare (less than 1% of all cases).
These side effects are more frequent when the patient:

• has already presented allergic reactions of the skin (urticaria, eczema, etc.) or respiratory system (asthma), food allergy or severe reaction to particular medication.
• suffers from a serious heart- or respiratory disease.
• takes particular medication, especially beta-blockers (for the heart or for hypertension).

If fluo-angiography still needs to be performed, pre-medication can be administered to prevent allergic reactions.

In a very few cases a serious shock may occur - with death as a possible consequence - even though all possible precautions have been taken.

If you are pregnant or breast-feeding

No complications following the injection of fluoresceine have been reported, whether for the mother or for the unborn child.
If the mother is breast-feeding, fluoresceine will be secreted into her milk. It is advisable to interrupt breast-feeding for 2 days following the examination.

Indocyangreen (ICG) - Angiography

What is Indocyangreen - Angiography?

An exam of the blood vessels of the eye fundus with the help of another fluorescent liquid, namely indocyangreen, allows us to determine a more detailed diagnose in case of age-committed macular degeneration.
This exam is also called infra-red angiography because we have the pigment lightened up with an infra-red light source. This pigment is also injected into a vain and the images are made with a digital camera system.

The angiography is recommended:

• With diagnose of certain eye affections, mamely age-committed macular degeneration of the wet type, with which the abnormal bloodvessels (choroïdale neovascularisation) can be visualised unsuficient with the fluorescention-angiography. The exam is preceded by a fluoangiography.
• To determine if the affection can or can not be treatened, par example by laser photocoagulation or photodynamic therapy.

How does the exam happen?

This exam is executed ambulant, hospitalisation is not necessary. The pupils have to be dillated. Therefor it is strongly recommended to be accompagnied of to use the public transportation, because driving yourself is impossible. Following a standard scheme, images are taken of the eye fundus and this for at least 45 minutes. This exam is in most cases well tolerated.

Side effects

Side effect without severeness are the following:

• Your stool will be couloured green after the injection of indocyan green.
• The injection is painless, except when the pigment is injected next to the vain, this incident is without consequences.

More about retinal diseases

Veinous trombosis
Chorioretinitis centralis
Macular holes
Myopic maculopathy
Fluorescein angiogram
Diabetic retinopathy
Macular degeneration