Fluorescein Angiography (FA) is a diagnostic procedure that allows evaluation of blood flow inside the retina and choroid.
After intravenous administration of a contrast agent called fluorescein, black and white pictures are taken showing the vascularity of the eye.
Fluorescein flows through the eye in the same way as blood, so if it begins to leak in some place, we know that this is where the blood vessels are damaged. The photographs show us the precise location of the leakage.
The most common indications for fluorescein angiography:
- assessment of the functional status and tightness of retinal vessels in order to detect vascular anomalies or pathologies arising in the course of retinal diseases, such as ocular complications in diabetes,
- assessment of possible damage to the retina and partially to the choroid resulting from degenerative or inflammatory changes,
- diagnosis of ocular tumours,
- evaluation of efficacy of laser photocoagulation, intravitreal injections, and other treatments,
- qualification for treatment.
What happens during fluorescein angiography
Before starting fluorescein angiography, a qualified nurse takes the medical history of the patient and administers pupil-dilating drops and intravenous contrast. Next an ophthalmologist, or a qualified radiographer, takes a series of photographs of the fundus, using an ultramodern retinal camera Topcon TRC Plus.
The examination takes about an hour, including waiting for pupil dilation.
Attention! Prior to the administration of the intravenous contrast the patient’s blood creatinine level must be checked.
The blood test can be done here at Retina. Since the result will be available after 1 working day, the test has to be performed at least one day before the scheduled appointment. We cannot perform fluorescein angiography before we know the patient’s blood creatinine level.
Patients can also have their blood creatinine levels tested at any laboratory beforehand, and just bring the test result to their appointment.
Contraindications to fluorescein angiography:
- hypersensitivity to fluorescein sodium contrast (an absolute contraindication!),
- renal or hepatic insufficiency (a relative contraindication – depends on the degree of insufficiency),
- heart diseases, such as coronary insufficiency and arrhythmia; cardiovascular diseases, such as hypertension and circulatory insufficiency (a relative contraindication – depends on the degree of insufficiency),
- diabetes (a relative contraindication – depends on the degree of insufficiency),
- pregnancy, especially in the first trimester (a relative contraindication, as no cases of fetal harm related to angiography have been identified to date)