Fluorescein angiography, or fundus imaging with contrast (AF)

Fluorescein angiography (AF) is an advanced diagnostic method used in ophthalmology, allowing detailed fundus imaging. The examination involves the intravenous administration of the contrast agent fluorescein, which, when exposed to UV light, emits fluorescence, allowing the vessels to be seen retina. Fluorescein angiography is particularly helpful in the diagnosis of retinal diseases, such as macular degeneration or diabetic retinopathy. Thanks to this method, it is possible to visualise any changes in the system of the blood vessels of the retina.

The examination makes it possible not only to diagnose eye diseases, but also to monitor the progress of treatment and diagnostic pathology in the vascular system of the eye. Through a series of fundus photographs it is possible to capture changes in detail, such as swelling, bleeding or changes in vascular structures, which are difficult to see in standard examinations. Fundus imaging in fluorescein angiography allows a very precise determination of the condition of the vessels, which is particularly important for therapy with modern methods such as laser treatment.¹

What is fundus imaging with contrast (AF)?

Fluorescein angiography is an advanced diagnostic method that allows precise fundus imaging. It involves the intravenous administration of a contrast agent, fluorescein, which, when exposed to UV light, emits fluorescence. Thanks to this property, it is possible to visualise the vessels in detail retina. This technique allows the detection of vascular lesions such as bleedings, swellings whether changes in vascular structure that are characteristic of different eye diseases, of which diabetic retinopathy and macular degeneration.

During AF tests shall be performed series of fundus photographs, which allow the flow of contrast to be traced through the retinal blood vessels. With this method, it is possible to monitor not only structural changes in the vessels, but also early detection of pathologies such as swellings and bleedings within the retina, which can lead to serious visual damage. Making fundus photography in this technique is particularly useful in the diagnosis of retinal diseases and in assessing the effectiveness of treatment.²

Fluorescein angiography of the eye - course of the examination

Fluorescein angiography consists of the intravenous administration of fluorescein contrast agent, which provides detailed images blood vessels of the retina. Fluorescein, when administered, emits light under the influence of UV light, allowing the blood flow to be accurately visualised in the vessels of the vascular membrane. In the course of the examination, the series of fundus photographs, which record the exact flow of contrast through the retinal vessels. With this method, even the smallest abnormalities in the vascular system of the eye can be detected.

Procedure AF tests It usually takes 10-20 minutes and does not require hospitalisation. During the examination, the patient may feel discomfort associated with the administration of the contrast agent, which manifests as a slight warmth within the body, especially in the arm area where the contrast is administered. In addition, the patient may experience flashes of light from the camera that takes the pictures. For some people, there may be intense colouring of the urine after the procedure, which is the result of contrast excretion. For this reason, patients are often advised to wear a sunglasses, as their eyes may be sensitive to light after examination.

Ocular angiography - how to prepare for the test?

Preparation for fluorescein angiography includes several key steps to ensure patient safety during performing fluorescein angiography:

• Informing the doctor about chronic diseases - The patient should inform the doctor of any chronic diseases, such as kidney failure, cardiovascular diseases, hyperthyroidism and other conditions that may affect safety AF tests. With this information, the doctor will be able to adapt the test plan to avoid adverse effects.
• Required tests – Blood analysis results and screening may be required to ensure that the patient is in the right condition to undertake the study. It is worth taking these tests, especially if the patient has a history of kidney disease, liver disease or other health problems.
• Pre-test medication - The patient may be asked to stop taking certain medications a few days before the fluorescein angiography study, especially if the measures you are taking may affect the body's response to the intravenous injection of shadowing agent. Medication recommendations depend on the patient's specific situation and the recommendations of the treating physician.

These preparatory steps aim to reduce the risk of adverse effects, such as allergic reactions whether vascular problems during eye examination. Adequate preparation for the examination increases its effectiveness and safety for the patient.

When to perform an AF test?

Fluorescein angiography is particularly suitable for the diagnosis and monitoring of various retinal diseases, such as:

• Diabetic retinopathy - Disease that can lead to vascular damage retina as a result of prolonged high blood sugar levels. AF testing allows early detection of changes in the retinal vascular system.
• Macular degeneration - It is one of the most common causes of sight loss in old age, and fluorescein angiography allows the vascular status of the macula to be assessed, making it possible to diagnose and monitor the progression of the disease.
• Observation of treatment effectiveness for the treatment of retinal tumours and for the treatment of laser - Thanks AF testing it is possible to accurately making the circulation visible in the retinal vasculature, allowing the effects of the applied therapy to be assessed and further treatment to be planned.

AF testing is also helpful in the diagnosis of optic nerve pathology and any other conditions related to the vascular system of the eye, making it essential in many clinical cases.

Contraindications to fundus imaging with contrast

Contraindications to fluorescein angiography include:

• Allergies to contrast media (fluorescein) - People who are allergic to fluorescein should not undergo AF testing, as this can lead to allergic reactions such as rashes, swellings or respiratory problems.
• Kidney problems - In the case of patients with kidney failure, the use of a contrast agent can be dangerous, as the contrast may not be properly excreted from the body, which can lead to complications.
• Pregnancy and breastfeeding – Use of contrast during pregnancy and breastfeeding is generally avoided unless there is a clear need, as there are no full studies on the safety of contrast effects on the foetus and infant.
• Heart diseases – Heart diseases, especially in severe forms cardiovascular diseases, may constitute a contraindication to performing fluorescein angiography, as the procedure may involve additional cardiovascular burdens.

All of these factors should be discussed in detail with your doctor before proceeding with the eye examination, to ensure the safety and effectiveness of the procedure.