Safety and efficacy of oral fluorescein angiography in detecting macular edema in comparison with spectral-domain optical coherence tomography.

Abstract

PURPOSE:

To evaluate the safety of oral fluorescein angiography (FA) and to compare its efficacy in detection of macular edema (ME) with spectral-domain optical coherence tomography (SD-OCT).

METHODS:

Results of imaging studies for 1,928 eyes of 1,019 patients who had simultaneously undergone both oral FA and SD-OCT by a confocal laser ophthalmoscope were reviewed. Sensitivity in detecting ME, discrepancy rate, and "kappa" agreement were determined for both the techniques and with eyes stratified by disease diagnosis.

RESULTS:

No allergic reactions occurred after oral FA. Mild gastric discomfort was noted in <1% of the patients; 1,840 eyes (95.4%) showed concordance between the two techniques, and kappa agreement was 90.3%. For ME, oral FA showed an overall sensitivity of 0.97 and SD-OCT of 0.91. Equivalent sensitivity was found in cases of wet age-related macular degeneration (0.99). Oral FA was more sensitive than SD-OCT in cases of retinovascular diseases. The SD-OCT showed higher sensitivity in cases of macular holes. Detection of ME by SD-OCT was significantly higher in cases of intense leakage on oral FA (P < 0.001).

CONCLUSION:

Oral FA proved to be a safe and an adequate technique to evaluate ME. It is more sensitive than SD-OCT in detection of ME in cases of retinovascular diseases but can fail to detect ME in cases of macular holes. A noninvasive examination with simultaneous oral FA and SD-OCT may be considered to obtain a comprehensive evaluation of the presence of ME from different pathologies.

• Authors: Giulio Barteselli, Jay Chhablani, Su Na Lee, Haiyan Wang, Sharif El Emam, Igor Kozak, Lingyun Cheng, Dirk-Uwe Bartsch, Stanley Azen, William R Freeman
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 33 Issue 8 Pg. 1574-83 (Sep 2013) ISSN: 1539-2864 [Electronic] United States
• PMID: 23584697 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Fluorescent Dyes
• Fluorescein

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Female
• Fluorescein (administration & dosage, adverse effects)
• Fluorescein Angiography (methods)
• Fluorescent Dyes (administration & dosage, adverse effects)
• Humans
• Macular Edema (diagnosis)
• Male
• Middle Aged
• Observer Variation
• Ophthalmoscopy
• Predictive Value of Tests
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, Optical Coherence (methods)
• Treatment Outcome
• Visual Acuity (physiology)
• Young Adult