1.The effect of fluorescein angiography on renal function: A meta-analysis and systematic review
Kevin Elissandro C. Gumabon ; Paolo Nikolai H. So ; Anne Margaret J. Ang
Acta Medica Philippina 2023;57(3):42-49
Background:
Contrast-induced nephropathy (CIN) is a complication that occurs in patients undergoing an imaging procedure with intravenous injection of contrast media, most notably iodinated dyes. Fluorescein angiography is a diagnostic procedure performed by ophthalmologists to determine abnormalities in retinal blood vessels. It uses sodium fluorescein, an organic dye, to capture and visualize these blood vessels. There have been conflicting data and practices on how to approach the procedure especially in patients with renal insufficiency.
Objective:
To determine the risk of CIN among patients undergoing fluorescein angiography.
Methods:
We searched PubMed, HerdIn, Cochrane Library, and Google Scholar, for published articles on the
topic. Other sources were searched for unpublished data or ongoing clinical trials. All research articles pertaining to fluorescein angiography and its effect on renal function with serum creatinine monitoring were included. Two independent authors separately screened records, assessed full texts, and extracted data. We used RevMan computer software to analyze data from the included studies. The primary outcome was the risk of CIN among patients undergoing fluorescein angiography based on the differences on serum creatinine levels and estimated glomerular filtration rates pre- and post-angiography, while the secondary outcome included risk factors for CIN.
Results:
A total of 6 studies were included in the meta-analysis. Four studies had poor quality as assessed using the Newcastle-Ottawa Scale. One study was deemed to have good quality. Data analysis showed that hemoglobin (p = 0.002) and albumin (p < 0.001) levels may be associated with CIN using sodium fluorescein but were not independent risk factors for CIN (multivariable logistic regression, p = 0.648 and p = 0.069, respectively); while sex, diabetes mellitus and chronic kidney disease were not significantly associated. As a primary outcome, only 6.8% of included patients had CIN with serum creatinine levels post-exposure showed significant differences from baseline values (mean difference 0.05; 95% CI 0.02, 0.07; I2 = 49%), but translating it to eGFR yielded non-significant differences (mean difference -0.37; 95% CI -2.33, 1.59; I2 = 0%).
Conclusion
Among patients undergoing fluorescein angiography, sodium fluorescein does not pose an increased risk for CIN.
fluorescein angiography
;
renal function
2.The Fluorescein Angiographic Findings of Chorioretinal Inflammation.
Dong Myung KIM ; Jae Heung LEE
Journal of the Korean Ophthalmological Society 1978;19(3):273-279
Artificial chorioretinal inflammation was produced by the application of the cryothermy, diathermy, or photocoagulation in man. The inflammatory reactions were followed-up by fluorescein angiography. Inflammatory lesion showed fluorescein leakage and pooling at the first postoperative day Cessation of leakage was seen niter the 10th postoperative dey regardless of method of inflammation production. Pigment stippling was seen at about 4-5 days after moderate to heavy cryo-application, but about 11-12 days after moderate intensity of photocoagulation and diathermy.
Diathermy
;
Fluorescein Angiography
;
Fluorescein*
;
Inflammation*
;
Light Coagulation
3.Multiple Evanescent White Dot Syndrome with Ebstein-Barr Virus Infection.
Journal of the Korean Ophthalmological Society 1998;39(4):790-794
Multiple Evanescent White Dot Syndrome is a clinical disorder of unknown etiology that affects primarily the retinal pigment epithelium and photoreceptors, usually manifests with acute visual loss or blurred vision. The course of MEWDS is recoverable over several weeks. Characteristic ocular manifestations may include multiple white dots in the deep retina of posterior pole, granularity of the macula, optic disc edema, and vitreous cells. Fluorescein angiography shows small punctate areas of hyper-fluorescence at the level of the retinal pigment epithelium corresponding to the white dots and late fluorescein staining, fluorescein leakage from disc capillaries. We experienced a case of suspected Multiple Evanescent White Dot Syndrome with Ebstein-Barr virus infection and reviewed the available literatures regarding the disease entity.
Capillaries
;
Edema
;
Fluorescein
;
Fluorescein Angiography
;
Retina
;
Retinal Pigment Epithelium
4.Clinical Studies on the Normal Retinal Circulation Times.
Jae Heung LEE ; Hong Duck KIM ; Chan Kyu OH ; Wan Seop SHIM ; Chul HONG
Journal of the Korean Ophthalmological Society 1973;14(4):301-306
After injection of See of 10% fluorescein sodium into the antecubital vein, the arm-to-retinal times of 22 normal adults were measured by watching through KOWA fundus camera (exciter filter: Fuji 18, barrier filter: Kodak Wratten 15G), and the retinal circulation times of 13 normal adults were measured with pictures of the serial fluorescein angiography by ZEISS fundus camera (exciter filter: Kodak Wratten 47A, barrier filter: Schott GG14). The normal ranges and the mean values of arm-to-retinal time and retinal circulation time are: 1. Arm-to-retina time; 9.0 sec. - 21.5 sec. (mean; 14.1 sec.). 2. Retinal circulation time; a. Early venous phase; 1.0 sec. - 5.0 sec. (mean; 2.6 sec.). b. Late venous phase; 4.5 sec. - 11.0 sec. (mean: 8.1 sec.).
Adult
;
Fluorescein
;
Fluorescein Angiography
;
Humans
;
Reference Values
;
Retinaldehyde*
;
Veins
5.Angiographic Findings in Patients with Vitelliform Macular Dystrophy.
Jung Yeal KIM ; Soo Young LEE ; In Taek KIM
Journal of the Korean Ophthalmological Society 2004;45(11):1917-1926
PURPOSE: To evaluated the fluorescein and indocyanine green angiographic findings (FAG and ICGA) of each stage in vitelliform macular dystrophy. METHODS: In this study (3 patients, 6 eyes), the stage of macula lesion was classified as follows: stage A (vitelliform), stage B (pseudohypopyon), stage C (scrambled egg), stage D (early cicatricial), and stage E (advanced cicatricial). RESULTS: At stage A, the lesion was hypofluorescent in the early phase and was hyperfluorescent in the late phase of both FAG and ICGA. At stage B, FAG showed hyperfluorescent in the upper portion and hypofluorescent in the lower portion of the lesion. ICGA showed hypofluorescent in the upper portion. However, ICGA showed hypofluorescent in the early and hyperfluorescent in the late phase in the lower portion. At stage C, the lesion was hypofluorescent in the early phase and hyperfluorescent in the late phase of both FAG and ICGA. At stage D, FAG showed hyperfluorescent and ICGA showed hypofluorescent. At stage E, FAG showed central hypofluorescent lesions and a hyperfluorescent ring. While ICGA showed typically hypofluorescent. CONCLUSIONS: The FAG and ICGA findings showed variable patterns according to the evolution of the lesion.
Fluorescein
;
Fluorescein Angiography
;
Humans
;
Indocyanine Green
;
Vitelliform Macular Dystrophy*
6.The Pattern and Location of the Choroidal Watershed Zone.
Tae Wan KIM ; Byung Ro LEE ; Myung Kyoo KO
Journal of the Korean Ophthalmological Society 1996;37(1):109-114
We have retrospectively studied the choroidal watershed zone of 217 eyes(217 patients) who visited ophthalmology department of Hanyang University Hospital. They all underwent fundus fluorescein angiography from 1988 to 1994. Choroidal watershed zones appeared in choridal or early arterial phase in fundus fluorescein angiography, and we classified them as five groups according to the location and pattern. In group 1, the watershed zone passed vertically through the entire disc and peripapillary choroid(58.9%); in group 2, the watershed zone passed vertically through temporal peripapillary choroid and temporal portion of the disc(19.4%); in group 3, the watershed zone passed vertically through nasal peripapillary choroid and nasal portion of the disc(15.7%); in group 4, the watershed zone passed through one or other section of disc(3.7%); in group 5, there was an island pattern on macular area alone(2.3%). Of these groups, there were island pattern on macular area with the pattern of each group, in the group 1; 43%, in the group 2; 52.3%, in the group 3; 20.5%, respectively. In conclusion, more than half of the cases showed the patterns of vertically elongated wide bands of watershed zone on entire or partial portion of disc and peripapillary choroid, and the remainders showed the similar patterns with an island on macular area.
Choroid*
;
Fluorescein Angiography
;
Ophthalmology
;
Retrospective Studies
7.Agreement between clinical and angiographic staging of diabetic retinopathy in a Tertiary Government Hospital in the Philippines
Philippine Journal of Ophthalmology 2022;47(1):9-14
Objective
The main objective of this study is to determine the agreement between the clinical staging of
diabetic retinopathy (DR) with fluorescein angiography (FA) staging in an actual clinic.
Diabetic Retinopathy
;
Fluorescein Angiography
;
Ophthalmoscopy
;
Diabetes Mellitus
8.A Study on Measurements of Retinal Blood Flow Using a Fluorescent Leukocyte Angiography.
Yun Sik YANG ; Yoo Kang KIM ; Jae Duck KIM
Journal of the Korean Ophthalmological Society 1996;37(2):284-292
This study was performed to develop a new method, fluorecent leukocyte angiography(FLAG), to measure retinal circulation. Fluorescein-stained leukocytes can be seen in all the retinal vessels during fluorescein angiography using Scanning Laser Ophthalmoscope(SLO FAG) and retinal blood flow can be measured by using leukocyte velocities in the retinal vessels. Methods were followings. Firstly, blood was withdrawn from vein, mixed with fluorescein(10%) and anticoagulant and then centrifuged. The yellowbrown coat layer containing fluorescin-stained leukocytes was selected and injected into the vein while performing SLO FAG. The image of FLAG displayed circulating hyperfluorescent leukocytes clearly in all retinal vessels, and allowed the measurement of leukocyte velocities. In conclusion, FLAG is a new method to measure blood flow in all the retinal vessels simultaneously and can be a useful tool for studying animal and human retinal circulation.
Angiography*
;
Animals
;
Fluorescein Angiography
;
Humans
;
Leukocytes*
;
Retinal Vessels
;
Retinaldehyde*
;
Veins
9.Peripheral Vascular Leakage Findings of Asymptomatic Eyes Based on Fluorescein Angiography.
Sang Hyup LEE ; Yong Un SHIN ; Byung Ro LEE ; Myung Kyoo KO
Journal of the Korean Ophthalmological Society 2014;55(7):1017-1023
PURPOSE: To report peripheral vascular retinal leakage findings of asymptomatic eyes based on fluorescein angiography, and investigate the associated factors. METHODS: Data were collected retrospectively from 47 subjects (94 eyes) and the peripheral leakage results based on fluorescein angiography were analyzed. The relationship between peripheral leakage findings and other factors including-arm-retinal circulation time (ARCT) and venous filling time (VFT), refractive error, age, hypertension, and diabetes- was evaluated. RESULTS: Ten eyes had peripheral leakage (21.3%). The mean age was 34.7 +/- 7.86 years in the non-leakage group and 44.3 +/- 9.63 years in the leakage group; the difference between the groups was statistically significant (p = 0.001). The mean spherical equivalent was -2.85 +/- 2.71 diopter in the non-leakage group and -3.46 +/- 3.62 diopter in the leakage group; the difference between the groups were not significant (p = 0.471). The mean ARCT was 10.50 +/- 2.06 seconds in the non-leakage group and 11.76 +/- 2.47 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.041). The mean VFT was 9.70 +/- 1.91 seconds in the non-leakage group and 10.75 +/- 1.40 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.048). CONCLUSIONS: Peripheral leakage can be found in asymptomatic eyes. Age, VFT, and ARCT were correlated to peripheral leakage findings based on angiography. These leakage findings were thought to be related with histological properties and physiological changes in peripheral retina.
Angiography
;
Fluorescein Angiography*
;
Hypertension
;
Refractive Errors
;
Retina
;
Retinaldehyde
;
Retrospective Studies
10.Fluorescein and Indocyanine Green Angiography of Choroidal Tumors.
Journal of the Korean Ophthalmological Society 1999;40(7):1866-1876
Fluorescein angiography (FAG) has been widely used in the diagnostic evaluation of choroidal tumors. Indocyanine green angiography (ICGA), which permits better visualization of choroidal vasculature than FAG, has been recently introduced into clinical practice. FAG and ICGA of 13 patients with choroidal tumors were assessed. These included 4 patients with choroidal nevus,4 with malignant melanoma, 2 with metastatic choroidal tumor,and 3 with choroidal hemangioma. In choroidal nevus, ICGA showed persistent hypofluorescence with clear delineation of the lesion in the late phase. Characteristic fluorescein angiographic feature of choroidal melanoma was hyperfluorescence in the late phase. However, the fluorescence of melanoma varied from hypo-,to hyperfluores- cent in the late phase of the ICGA. In choroidal metastatic tumor, FAG showed the typical pinpoint hyperfluorescence in the early phase and the diffuse leakage with serous detachment in the late phase. ICGA showed the hypofluo- rescence throughout the whole phases. In choroidal hemangioma, FAG and ICGA showed complete dye filling of the hemangioma with more denser hyperfluorescence in the early phase than in the late phase. In all patients, the lesion was better defined on the ICGA than on the FAG. This study suggests that ICGA combined with FAG may be useful in differentiating various choroidal tumors.
Angiography*
;
Choroid*
;
Fluorescein Angiography
;
Fluorescein*
;
Fluorescence
;
Hemangioma
;
Humans
;
Indocyanine Green*
;
Melanoma
;
Nevus