The hazards of fundus angiography

Fundus angiography is a medical procedure in which a fluorescent dye is injected into the bloodstream. This dye highlights the blood vessels at the back of the eye for easier photography. This test is often used to treat eye diseases. Your doctor may use it to confirm a diagnosis and determine appropriate treatment, or to monitor the condition of the blood vessels behind your eye. Fundus angiography is generally used to determine whether the blood vessels at the back of the eye are getting enough blood flow, but it can also be used to help diagnose eye diseases such as macular degeneration or diabetic retinopathy. However, fundus angiography also has risks.

Generally speaking, it is safe for most people to undergo fundus angiography, but contrast agents need to be injected intravenously during the process. Contrast agents are toxic to a certain extent, and there is a risk of systemic accidents in rare cases. Therefore, the following situations cannot undergo fundus angiography examination.

(1) Allergic constitution: Patients with a clear history of drug allergy are prohibited from undergoing fundus angiography examination. Patients with a history of iodine allergy (seafood allergy) are not allowed to undergo ICGA examination.

(2) This examination is prohibited for patients with asthma.

(3) Patients with cardiovascular disease or heart, liver, and kidney dysfunction should be cautious when undergoing this examination. You need to tell the clinician the truth, and the doctor will evaluate and decide whether the examination can be performed.

(4) This examination is prohibited for women in early pregnancy, breastfeeding, advanced cancer patients, patients in poor general condition, and mentally ill patients.

(5) This examination is prohibited for those with blood pressure greater than or equal to 160/100 mmHg.

(6) Those who are contraindicated in mydriasis cannot undergo this examination.

Preventive measures: (1) Before angiography: inquire in detail about the patient's medical history and history of drug allergies. It is contraindicated for those who are allergic to sulfonamide drugs, those with a history of allergic asthma or other allergies, those with severe liver and kidney damage, and pregnant women. Patients with diabetes and hypertension should control their blood sugar and blood pressure. Before the examination, the purpose and method of the examination should be explained to the patient and his family to eliminate the patient's nervousness. At the same time, inform patients and their families of the possible risks so that they can be fully prepared and pay attention to any adverse reactions. (2) During angiography: If nausea, vomiting, pale complexion, cold sweats, etc. occur, the examination should be suspended and the patient should be allowed to lie down and rest. The lights and doors should be turned on to ventilate the room, and the patient should be comforted to relieve his or her anxiety. After the patient's symptoms improve, continue with the angiography examination. For severe allergic reactions, dexamethasone injection 10 mg + 5% glucose injection 40 ml or 0.9% sodium chloride injection 40 ml can be given by slow intravenous injection to establish an intravenous channel. If necessary, ask an internist to assist in diagnosis and treatment. (3) After angiography: All patients must stay for observation for 30 minutes after examination. The patient can be allowed to leave only after no adverse reactions are observed.

Adverse reactions to fluorescein sodium may occur within seconds or minutes after administration or several days after the angiography examination. In very rare cases of severe illness, untimely rescue may endanger the patient's life. Therefore, medical staff should attach great importance to it, take precautions, and strictly follow the indications. For elderly and frail patients, or patients with unstable systemic diseases, they should consider temporarily not doing or postponing angiography.