Fluorescein Angiography (IVFA)

What is a fluorescein angiography? (Flor-eh-seen Angie-og-ra-fee)
Fluorescein angiography is a very important diagnostic procedure. A highly specialized digital camera is used to take a series of photographs of the retina, (the light sensitive tissue in the back of the eye.) This information is then stored as a digital computer image.

YOU WILL BE DILATED FOR THIS PROCEDURE, SO BRING A DRIVER PLEASE.

To produce these unique pictures, a water soluble dye (fluorescein) is injected into a vein in the patient's arm. The dye travels through the veins and arteries to the eye and the body. (No iodine dye is used, as in X-Ray angiograms, which makes an angiogram of the eye very safe. People allergic to "X-Ray dye" are not allergic to fluorescein, since they are completely different agents.)

As the fluorescein passes through the blood vessels of the retina, a special camera flashes a blue light into the eye and takes multiple photographs of the retina and the DEEPER TISSUE BEHIND THE RETINA CALLED THE CHOROID. The choroid is generally invisible during direct visualization of the retina.

Any abnormal blood vessels, bleeding or other retinal problems will be revealed by the fluorescein angiogram. The precise location of these abnormalities will be determined by a careful interpretation of the fluorescein angiogram by Dr. D.

Why do I need a fluorescein angiogram?
Intravenous fluorescein angiogram is the best way to diagnose and follow a number of conditions that involve the eye. The angiogram reveals pathology that cannot be seen using normal routine observational techniques. Furthermore, angiograms allow precise location of abnormal tissue which may facilitate better treatment of your condition. Lastly, angiograms are very useful for following the progression of a condition by repeating the angiograms over time and monitoring any changes.

Some of the conditions followed with fluorescein angiogram include diabetic retinopathy, age related macular degeneration, swelling, pigmented or suspicious lesions of the retina.

Age-related macular degeneration is the leading cause of blindness in patients over the age of 55. In some cases, small blood vessels that would be otherwise invisible can be seen under the retina which can be treated with a laser in an attempt to prevent severe visual loss.

What are the risks of fluorescein angiography?
After the fluorescein dye is injected, your skin may turn yellowish for several hours. This color disappears as the dye is filtered out of the body by the kidneys. Because the dye is removed by the kidneys, your urine will turn dark orange for up to 24 hours following the test.

A few individuals may experience slight nausea during the procedure, but this usually passes within a few seconds. If the dye leaks out of a fragile vein during the injection, localized burning and yellow staining of the skin may occur. This burning usually lasts only a few minutes and the staining will go away in a few days.

Allergic reactions to fluorescein dye are VERY RARE. If they occur, they may cause a skin rash and itching. This is usually treated with oral or injectable antihistamines, depending on the severity of the symptoms.

Life threatening allergic reactions (anaphylaxis) are EXTREMELY RARE. Being allergic to x-ray dyes which contain iodine does not mean that you will be allergic to fluorescein.

Dilation Protocol
Dilation is one of the most time consuming portions of the entire angiogram procedure; therefore, to increase efficiency and decrease our patients' wait time, we recommend that our patients arrive at our clinic with their eyes already dilated.

On the office visit preceding your angiogram procedure, you will be given a sample of a dilating drop, i.e. a red top drop. We ask that you begin putting one to two drops in both eyes starting two hours, then one hour, and finally half an hour before your next appointment time. As stated above, you may be more comfortable having a driver come with you for this procedure due to the dilation.

Why are regular medical eye exams important for everyone?
Eye disease can occur at any age. Many eye diseases do not cause symptoms until the disease has done extensive damage. Since most blindness is preventable if diagnosed and treated early, at least yearly exams from Dr. D are recommended.