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Fluorescein Angiography

Fluorescein Angiography

What is a Fluorescein Angiogram?
A fluorescein angiogram (FA) is an imaging test used to evaluate the retinal blood vessels. Fluorescein is a vegetable based dye that is injected into a vein in the arm and as it circulates through the retinal blood vessels a special camera is used to take photographs. The camera has a specific flash that makes the dye “light-up” and become visible to the camera’s sensor. Any abnormality to the blood flow, abnormal blood vessels, or leaking blood vessels can be identified.
 
What conditions are FA’s used to diagnose?
Any condition that damages the retina’s blood vessels or has abnormal blood vessel growth can be both diagnosed and monitored with a fluorescein angiogram. Most frequently Retinal Vascular Occlusions, Diabetic Retinopathy, Age Related Macular Degeneration are assessed with an FA.
 
How is the test performed?
After positioning at the camera, several photographs are taken of the retina. Then, a small IV is started in the arm and the fluorescein dye is injected. As soon as the dye starts to circulate multiple photos are taken to follow with flow through the blood vessels. Once the initial photos are taken, the dye is allowed to circulate and additional photos are taken over the next several minutes.

Early fluorescein transit

Venous filling of fluorescein

Peak fluorescence

Late fluorescent phase

What are the risks?
Anytime an IV is started there is a small risk of infection, to prevent infection the skin is carefully cleaned prior to insertion of the IV. The fluorescein dye is vegetable based and very inert but some people have an allergy to the medication. Reactions can be mild with hives or severe with problems breathing. Medication to treat an allergic reaction is on hand but severe reactions will need to be evaluated at the emergency room. Fortunately, the incidence of severe allergy is very rare, if you have ever had any allergic reaction to fluorescein it is important to tell your doctor. Sometimes the medication can cause some mild nausea that passes quickly after the medication is injected. For 1-2 days after the exam, the fluorescein can make the skin appear slightly orange or tan and as the medication is excreted through the kidneys will turn the urine a bright orange. 
Dr Kruti Dajee Dr Jawad Qureshi Dr Johnathan Warminski