Fluorescein Angiography

What is a fluorescein angiogram?

A fluorescein angiogram is one of the most important tests for diagnosing retinal disease. It involves injecting a special dye (fluorescein) into a vein in your arm. The dye then travels through the systemic circulation into the blood vessels of the retina, at the back of the eye. Once the dye reaches the retina, special photographs are taken to determine the health of the circulation.

Fluorescein angiography is most commonly used in diseases such as:

What can I expect during an angiogram?

You will have the procedure explained to you in detail and then be asked to sign a consent form. Following that, a small needle will be inserted into a vein in your arm.

The fluorescein dye will be injected through the needle into your blood stream. At that stage, it is not uncommon to feel slight nausea for a couple of seconds. As the dye is injected, the photographer will start taking pictures of the back of your eye.

Photos will continue to be taken for about 5 minutes. After that, the needle will be removed, and you will be asked to wait for up to half an hour. Usually at this time, you will see Dr Johnson, who will go through the results of the angiogram with you and recommend any treatment that you may need.

What can I expect after an angiogram?

Your skin will take a slightly yellow colour for up to 1 day. Also, as the dye is excreted through the kidneys, your urine will have a dark orange colour.

What are the risks of fluorescein angiography?

Fluorescein angiography is generally considered a safe procedure. Most people have no significant side effects (other than temporary changes to skin and urine colour). 

Occasionally some patients feel nauseous as the dye is injected, but this only lasts a few moments. It is uncommon to vomit or faint. 

About 1 in 40 people will have a sore arm after the procedure; this usually takes several days to settle. 

An allergy to the fluorescein dye is rare. Most people who are allergic to the dye will notice a rash, or itchy skin up to 30 minutes after the injection. This is usually treated with antihistamines. It is very rare to have a severe allergy (anaphylaxis). Although extremely rare, death has been reported following fluorescein angiograms. The risk is 1 in 200,000. This is usually due to severe anaphylaxis, strokes and heart attacks. 

What does a normal angiogram look like?

Blood flows through both the retinal and choroidal circulations in the eye. It reaches the choroidal circulation first, and then the retinal circulation. After the retinal arteries fill, the blood fills the retinal veins and exits the eyes.  

Arterial phase:

Early venous phase:

Venous phase: 

Late phase:

Dr Joshua Yuen

Dr Joshua is an experienced consultant ophthalmic surgeon, who specialises in retinal diseases and cataract surgery... read more

Dr Brad Johnson

Dr Johnson is an experienced consultant ophthalmic surgeon, who specialises in retinal diseases and cataract surgery... read more