Skip Navigation LinksHome > September 2013 - Volume 33 - Issue 8 > SAFETY AND EFFICACY OF ORAL FLUORESCEIN ANGIOGRAPHY IN DETEC...
Retina:
doi: 10.1097/IAE.0b013e318285cd84
Original Study

SAFETY AND EFFICACY OF ORAL FLUORESCEIN ANGIOGRAPHY IN DETECTING MACULAR EDEMA IN COMPARISON WITH SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

Barteselli, Giulio MD*,†; Chhablani, Jay MD*; Lee, Su Na MD*; Wang, Haiyan MD*; El Emam, Sharif MD*; Kozak, Igor MD*; Cheng, Lingyun MD*; Bartsch, Dirk-Uwe PhD*; Azen, Stanley PhD; Freeman, William R. MD*

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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.

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