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
•
