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Randomized, Comparative Study of Full- and Half-Dose Fluorescein Angiography
Vaama Patel1, Sarah Syeda1, John Zeiter1
1Department of Ophthalmology, Visual and Anatomic Sciences and the Kresge Eye Institute, Wayne State University School of Medicine, Detroit, MI, USA.
Journal of Vitreoretinal Diseases
|April 3, 2023
Summary
A reduced 250-mg dose of fluorescein in digital ultra-widefield (UWF) angiography provides comparable image quality to the standard 500-mg dose. This finding supports the use of half-dose fluorescein angiography for most clinical assessments using UWF technology.
Area of Science:
- Ophthalmology
- Medical Imaging
Background:
- Fluorescein angiography (FA) is a crucial diagnostic tool in ophthalmology.
- Ultra-widefield (UWF) imaging technology enhances visualization of the peripheral retina.
- Optimizing fluorescein dosage is important for patient comfort and resource management.
Purpose of the Study:
- To compare the image quality of a half-dose (250 mg) fluorescein angiography with the standard full-dose (500 mg) using digital UWF technology.
- To determine if reduced fluorescein dosage impacts diagnostic accuracy in UWF imaging.
Main Methods:
- A randomized, prospective study was conducted comparing half-dose and full-dose FAs using a UWF imaging system.
- Four reviewers assessed images based on dye transit, macrovasculature, macula detail, microvasculature, leakage, and overall quality.
- Fuzzy rating scores were used to confirm findings for specific parameters.
Main Results:
- Seventy-nine FAs from 67 patients were analyzed.
- Microvasculature showed a statistically significant difference between half and full doses (P=.04), with full dose scoring higher.
- No significant differences were found in dye transit, macrovasculature, macula detail, leakage, or overall quality, particularly in patients who underwent both half and full dose FAs.
Conclusions:
- A 250-mg dose of fluorescein in UWF imaging yields results comparable to a 500-mg dose for most assessed parameters.
- Overall image quality was not significantly different between the two doses.
- The half-dose fluorescein angiography is a viable alternative to the full dose for UWF imaging, except possibly for detailed microvascular assessment.
