Fluorescein Angiography: Purpose, Procedure and Results
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Fluorescein Angiography

What Is a Fluorescein Angiography?

A fluorescein angiography is a medical procedure in which a fluorescent dye is injected into the bloodstream. The dye highlights the blood vessels in the back of the eye so they can be photographed.

This test is often used to manage eye disorders. Your doctor may order it to confirm a diagnosis, determine an appropriate treatment, or monitor the condition of the vessels in the back of your eye.

What the Test Addresses

purpose

Your doctor may recommend a fluorescein angiography to determine if the blood vessels in the back of your eye are getting adequate blood flow. It can also be used to help your doctor diagnose eye disorders, such as macular degeneration or diabetic retinopathy.

Macular Degeneration

Macular degeneration occurs in the macula, which is the part of the eye that allows you to focus on fine detail. Sometimes, the disorder worsens so slowly that you may not notice any change at all. In some people, it causes vision to deteriorate rapidly and blindness in both eyes may occur.

Because the disease destroys your focused, central vision, it prevents you from:

  • seeing objects clearly
  • driving
  • reading
  • watching television

Diabetic Retinopathy

Diabetic retinopathy is caused by long-term diabetes and results in permanent damage to the blood vessels in the back of the eye, or the retina. The retina converts images and light that enter the eye into signals, which are then transmitted to the brain through the optic nerve.

There are two types of this disorder:

  • non-proliferative diabetic retinopathy, which occurs in the initial stages of the disease
  • proliferative diabetic retinopathy, which develops later and is more severe

Your doctor may also order fluorescein angiography to determine if treatments for these eye disorders are working.

Preparation for the Test

Diagnosis Icon

You’ll need to arrange for someone to pick you up and drive you home since your pupils will be dilated for up to 12 hours after the test.

Be sure to tell your doctor before the test about any prescriptions, over-the-counter drugs, and herbal supplements you’re taking. You should also tell your doctor if you’re allergic to iodine.

If you wear contact lenses, you’ll need to take them out before the test.

How Is the Test Administered?

process

Your doctor will perform the test by inserting standard dilation eye drops into your eyes. These make your pupils dilate. They’ll then ask you to rest your chin and forehead against the camera’s supports so that your head remains still throughout the test.

Your doctor will then use the camera to take many pictures of your inner eye. Once your doctor has completed the first batch of pictures, they’ll give you a small injection into a vein in your arm. This injection contains a dye called fluorescein. Your doctor will then continue to take pictures as the fluorescein moves through the blood vessels into your retina.

What Are the Risks of the Test?

Risk Factors

The most common reaction is nausea and vomiting. You could also experience dry mouth or increased salivation, increased heart rate, and sneezing. In rare cases, you may have a serious allergic reaction, which can include the following:

  • swelling of the larynx
  • hives
  • difficulty breathing
  • fainting
  • cardiac arrest

If you’re pregnant or think you may be, you should avoid having a fluorescein angiography. The risks to an unborn fetus are not known.

Understanding the Results

Results/Exams

Normal Results

If your eye is healthy, the blood vessels will have normal shape and size. There will be no blockages or leaks in the vessels.

Abnormal Results

Abnormal results will reveal a leak or blockage in the blood vessels. This may be due to:

  • a circulatory problem
  • cancer
  • diabetic retinopathy
  • macular degeneration
  • high blood pressure
  • a tumor
  • enlarged capillaries in the retina
  • swelling of the optic disc

What to Expect After the Test

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Your pupils can remain dilated for up to 12 hours after the test is performed. The fluorescein dye may also cause your urine to be darker and orange for a few days.

Your doctor may have to order more lab tests and physical exams before they’re able to give you a diagnosis. 

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