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Published on: March 11, 2016
Pediatric oral fluorescein angiography: a retrospective review from a single institution
Elizabeth A Conner1, Amgad Eldib1, Jamila G Hiasat1
1University of Pittsburgh Medical Center (UPMC) Eye Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Children's Hospital of Pittsburgh of UPMC Division of Pediatric Ophthalmology Strabismus and Adult Motility, Pittsburgh, Pennsylvania.
Insights
Oral fluorescein angiography (FA) is safe and effective for pediatric retinal imaging when evidence-based guidelines are followed. Adherence ensures adequate imaging, with minimal transient side effects reported in children.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Medical Imaging
Background:
- Oral fluorescein angiography (FA) offers an alternative for retinal imaging in pediatric patients.
- Developing evidence-based guidelines is crucial for optimizing safety and efficacy.
Purpose of the Study:
- To evaluate the experience with locally developed, evidence-based guidelines for oral FA in children.
- To assess the safety and effectiveness of oral FA in a pediatric population.
Main Methods:
- Retrospective review of medical records for pediatric patients (≤18 years) who underwent oral FA.
- Analysis of adherence to established guidelines and documentation of any deviations.
- Data collected between November 1, 2018, and April 1, 2022.
Main Results:
- 55 pediatric patients (ages 3-18) with 79 examinations were included.
- Common indications included uveitis, retinal vasculopathy, disk pathology, and retinal lesions.
- High adherence to guidelines (78/79) resulted in adequate imaging; one case of suboptimal imaging was linked to protocol nonadherence. Three children experienced transient side effects, and one had delayed urticaria; no anaphylaxis occurred.
Conclusions:
- Oral FA is a recommended procedure for pediatric retinal imaging, particularly when intravenous access is challenging.
- Informed consent should address the potential for delayed side effects.
- Adherence to evidence-based guidelines ensures diagnostic image quality and patient safety.
Purpose:
To describe our experience with locally developed evidence-based guidelines for oral fluorescein angiography (FA) for retinal imaging in children.
Methods:
The medical records of consecutive pediatric patients (≤18 years of age) at University of Pittsburgh Medical Center Children's Hospital Eye Center who underwent oral FA between November 1, 2018, and April 1, 2022, were reviewed retrospectively. Adherence to or deviation from the guidelines was noted at the time of testing.
Results:
A total of 55 patients aged 3-18 with 79 examinations were included. No patient was excluded from the retrospective case review because of lack of recorded data. The main indications for oral FA included uveitis, retinal vasculopathy, disk pathology, and retinal lesions. Three children had transient side effects, and 1 had delayed urticaria 4 hours after examination. No child had anaphylaxis. One patient had suboptimal imaging due to nonadherence to the guidelines-recommended fasting protocol. All other examinations (78/79), where guidelines were followed, provided images adequate for clinical decision making.
Conclusions:
Based on our experience, we recommend that oral FA be considered, especially in children where intravenous access is less well tolerated while awake. Informed consent that includes the possibility of delayed side effects is advisable.
