Fundus Fluorescein Angiography

Fluorescein angiography is a diagnostic photographic test of the retina, the ‘film’ in the back of the eye using a dye called fluorescein.

Fluorescein angiography is used to diagnose certain eye conditions and to plan or guide treatment. The common eye diseases that require fluorescein angiography include diabetic retinopathy, macular degeneration and retinal vascular diseases.

Your pupils will be dilated with eye drops to allow the retina to be photographed. Once your pupil is dilated, a series of photographs are taken. A needle is placed into your arm and Fluorescein dye is then injected. Fluorescein travels through the body to reach the blood vessels of the eye. Photographs are further taken as the dye passes through the blood vessels, providing useful information about the retina and nearby tissues. Once the photographs are taken, the needle will be removed.

After fluorescein angiography, your skin will turn yellow for several hours. This will fade as the dye is filtered out by the kidneys – this leads to the urine turning a dark yellow colour for up to 24 hours. Your vision will be blurred and you should not drive for at least four hours after the angiogram, but there is no permanent effect on the vision from having the test done.

Fluorescein angiography is a safe and very helpful test. Many fluorescein angiograms are performed every year throughout Australia and New Zealand. The chance of adverse effects is low, but as with any medical procedure, there are some risks involved. Some patients experience nausea or vomiting. Occasionally, some fluorescein will leak from a fragile vein, which may cause a localised burning and yellow staining of the skin. The burning usually lasts a few minutes and the staining takes a few days to disappear. Some patients may experience allergic reactions to the fluorescein dye. The most common allergic reaction is skin rash or itchiness. More severe allergic reactions are rare.

The more severe allergic reaction is called anaphylaxis, which is rare but can be sight threatening. Patients may experience breathing difficulty or heart rhythm disturbances, which can be severe and even cause death. . If you develop any itching, tingling in the lips or tongue, difficulty in breathing or pain during or after the angiogram, please let us know immediately. You may require medication to control the reaction and your condition will be monitored until it has resolved. Delayed reactions are very uncommon, but it is important that you tell us if you experience any delayed effects that you feel may be related to your fluorescein angiogram.

Please inform us about any health conditions that you may have, all the medications that you are taking, and especially any allergies to medications that you have had in the past. It is preferred you bring this information as a letter from your doctor. If you have had a previous fluorescein angiogram, please let us know. You do not need to fast for this test.

Fluorescein is reported to be safe in pregnancy, but we prefer to avoid this test in pregnant patients if possible. Please advise if you are pregnant, or suspect you could be pregnant.