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Fluorescein Angiography. Digre , Corbett.

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Presentation Transcript
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First introduced in 1960, sodium fluorescein, a dye, is administered through an angiocatheter (3-5cc) by a nurse or technician. Indocyanine green is another form of angiography, mor utilized for visualization of the choroidal than the central retinal circulation.

Setting up the injection of fluoresceinfor Fluorescein Angiography.

sequences of fluorescein angiography
Sequences of Fluorescein Angiography
  • The dye reaches the central retinal artery after passing through the heart and lungs in about 8-14 seconds.There really are two vasculatures that are viewed almost simultaneously-- the retinal vasculature (central retinal artery as a branch off the ophthalmic artery) and the choroidal vasculature (from the posterior ciliary artery circulation). The first thing to "light up" is the choroid and optic disc. The retinal arterioles then illuminate using a red free light, and the capillary bed and veins will be visible at about 12-18 seconds. We speak of the arterial phase (that is the filling of the central retinal artery), the capillary phase (the filling of the small vessels including the choroid). The early venous phase shows laminated flow first, and finally the venous phase (the filling of the veins).
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(A) The red free photograph before dye is injected

(B) The first hint of dye arrival is in the choroid and then the central retinal artery

(C) Once the arteries are filled, there is laminar flow in the veins. Notice the stripe in the veins

(D) All of the vessels are filled,arteries and veins and choroid

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(F) Even later, 10.27 minutes, the dyehas almost left the fundus.

(E) Later, 6.04.6 minutes the dye is fading. If there are abnormalities like disc staining you begin to see it now.

dye leakage
Dye Leakage

The term "dye leakage" is used for pathologic conditions within the ocular circulation where the vessels become permeable to fluorescein.Whereas "staining" is the direct result of leakage--from an inflammatory exudate, a scar, or an altered vessel wall.

(A) Normal disc staining

(B) Photograph of dye staining of the disc

(C) Photograph of dye leakage of the disc

fluorescein blockage
Fluorescein Blockage

(C) A view of the clinical appearance of a pre-retinal hemorrhage. This patient has multiple laser marks due to neovascularization.

(B) Fluorescein of a pre-retinal hemorrhage due to neovascularization