Fluorescein angiography

Fluorescein angiography

This examination consists of taking photographs of your eye fundus after injecting a fluorescent dye (fluorescein, indocyanine green) into a vein, usually at the elbow (i.e. like a blood test). It is an irreplaceable way of finding out the state of the vessels in the back of your eye and mainly those in your retina.

Angiography is indicated for :
– establish the diagnosis of certain diseases of the eye,

– guide treatment, particularly when laser photocoagulation is being considered.

The most frequent indications for angiofluorography are diabetic retinopathy and retinal degeneration.

This examination is performed on an outpatient basis (no hospitalisation) but requires you to dilate your pupils. This is why it is recommended that you come by public transport or accompanied, as it will be impossible for you to leave while driving your car. Fundus images are taken at close range for at least 5 to 10 minutes and sometimes longer.

The examination is well tolerated in most cases, except for possible side effects that are not serious:
– Your skin and urine will be coloured yellow for several hours after the injection of fluorescein; your stools will be coloured with indocyanine green.

– The intravenous injection of the product is painless, unless the dye is injected outside the vein. This incident is otherwise of no consequence.
– Nausea is quite frequent, and more rarely vomiting, after the injection of the product. These incidents are not dangerous. If you have already experienced this during a previous angiography, report it to your ophthalmologist. Taking medication before the examination will improve your comfort and avoid interrupting the taking of photographs.
– You may feel uncomfortable, but this will disappear quickly if you lie down.
Serious intolerance reactions can occur unpredictably. Fortunately, they are very rare (less than 1% of cases).

The risk increases :
– if you have already had skin or respiratory allergies (hives, eczema, asthma), or food allergies, or after taking certain medicines,
– if you have a major heart or respiratory disease,
– if you are taking certain medicines, in particular beta-blockers (for the heart, high blood pressure).

This is why your ophthalmologist will ask you to fill in the attached questionnaire before performing the angiography. In case of doubt, do not hesitate to ask for additional information and, if necessary, bring any medical documents you may have relating to this problem.
If angiofluorography is indicated, you may be offered oral or injection premedication to prevent or limit intolerance and allergy reactions.
Exceptionally, despite all the precautions taken, a serious shock, sometimes fatal, may occur in an unforeseeable way.

 

These complications can occur during the examination or shortly afterwards. Therefore, for your safety, you are asked to wait about 30 minutes in the waiting room after the angiography is completed before going home.

In case of pregnancy, no complications due to fluorescein have been reported, neither for the mother nor for the unborn child. For indocyanine green, there is no known toxic effect, but, as a precaution, this examination should be avoided during the first months of pregnancy.
If you are breast-feeding, as fluorescein is excreted in breast milk, it is recommended that you discontinue breast-feeding for two days after the examination.

For indocyanine, the effects of breastfeeding are not known.

Questionnaire to be completed before fluorescein and/or indocyanine retinal angiography

To reduce the risk of intolerance, we ask you to answer the following questions:
– Last name,
– First name,
– Date of birth,
– Have you ever had any allergies, skin or respiratory reactions, especially to certain drugs or foods (shellfish), or after an anaesthetic?
– Do you suffer from heart disease?
– Do you suffer from asthma?
– Are you taking heart medication or medication for high blood pressure (beta-blockers)?
– Have you ever had a bad experience with angiofiuorography?
– Are you pregnant?
After this explanatory interview with the doctor, I agree to undergo an angiography – with fluorescein,
– with indocyanine.