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Diabetic Retinopathy

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7 Fluorescein Angiography Î If used appropriately, fluorescein angiography ancillary to the clinical examination may enhance patient care. (III, In, D) Î Fluorescein angiography is useful for identifying capillary dropout and pathologic enlargement of the foveal avascular zone, a feature that may be useful when planning treatment. (III, G, D) Î Fluorescein angiography prior to laser surgery for clinically significant macular edema (CSME) is often helpful for identifying treatable lesions. (III, G, D) Î Routine fluorescein angiography is NOT indicated as a part of the regular examination of patients with diabetes. (III, G, S) Î Facilities for fluorescein angiography should be available to physicians who diagnose and treat patients with diabetic retinopathy. (II++, G, D) Î Each angiography facility should have in place an emergency care plan and a clear protocol to minimize the risks and to manage complications. (III, G, S) Î Fluorescein angiography may be helpful to determine the presence or absence of areas of nonperfusion and/or clinically undetected areas of retinal neovascularization and to establish the cause for a loss in visual acuity. (III, M, D) Table 5. Use of Fluorescein Angiography for Diabetic Retinopathy Situation Usually Occasionally Never To guide laser treatment of clinically significant macular edema • To evaluate unexplained visual loss • To identify suspected but clinically obscure retinal neovascularization • To identify areas of vitreomacular traction • To rule out other causes of macular swelling • To identify large areas of capillary nonperfusion • To evaluate patients with difficult and/ or questionable examinations for diabetic macular edema • To screen a patient with no or minimal diabetic retinopathy •

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