Adverse effects of fluorescein angiography in hypertensive and elderly patients

To evaluate adverse effects in patients undergoing fundus fluorescein angiography (FA), and to assess the level of these adverse effects in hypertensive and elderly patients.

We carried out a retrospective study of 358 patients undergoing FA. They were assessed for adverse effects and their relationship to medical history, pre- and post-FA blood pressure and age.

The overall adverse reaction rate (AR) was 11.2%, the majority (80%) of which involved nausea. There were no mortalities and no cases of anaphylaxis or cardiac arrest. Hypertension (systolic or diastolic) did not increase the AR. Interestingly, raised initial systolic blood pressure (BP) > or = 160 showed a statistically significant decreased AR compared with that for BP < 160 (7% versus 15%, respectively; p = 0.04). There was no statistical correlation between AR and age.

FA is a relatively safe procedure, but serious side-effects have been reported in the past and therefore adequate measures need to be in place to cope with such emergencies. In our study, there was no increase in the incidence of adverse effects in patients who were hypertensive or elderly. Therefore, these patients should not be denied an important diagnostic procedure that may improve their quality of life purely because of hypertension or age.