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The fluorescein is administered intravenously in intravenous fluorescein angiography (IVFA) and orally in oral fluorescein angiography (OFA). The test is a dye tracing method. The fluorescein dye also reappears in the patient urine, causing the urine to appear darker, and sometimes orange. [2] It can also cause discolouration of the saliva.
From a physics perspective, both dye-based methods utilize the phenomenon of fluorescence. For FA, this corresponds to an excitation wavelength of blue (around 470 nm) and an emission wavelength near yellow (520 nm). [49] For IGCA, the newer method, the excitation wavelength is between 750 and 800 nm while emission occurs above 800 nm. [50]
The first version of the LEA test was developed in 1976 by Finnish pediatric ophthalmologist Lea Hyvärinen, MD, PhD. Dr. Hyvärinen completed her thesis on fluorescein angiography and helped start the first clinical laboratory in that area while serving as a fellow at the Wilmer Eye Institute of Johns Hopkins Hospital in 1967.
Optical coherence tomography (OCT) is a technology using near-infrared light to image the eye, in particular penetrate the retina to view the micro-structure behind the retinal surface. Ocular OCT angiography (OCTA) is a method leveraging OCT technology to assess the vascular health of the retina. [15]
Digital subtraction angiography (DSA) is a fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a "pre-contrast image" or mask from subsequent images, once the contrast medium has been introduced into a ...
Fluorescein is a dye which is taken up by damaged cornea such that the area appears green under cobalt blue light. [3] There is also a version that comes premixed with lidocaine. [4] [8] Fluorescein was first made in 1871. [9] It is on the World Health Organization's List of Essential Medicines. [10]
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If the results of the ultrasound and intracranial imaging are normal, "renewed diagnostic efforts may be made," during which fluorescein angiography is an appropriate consideration. However, carotid angiography may not be necessary in the presence of a normal ultrasound and CT. [42]