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Interpretation
of
fluroescein angiography: I
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When interpreting fluorescein angiography, the simultaneous use of colour picture fundal is recommended. If
you were in a viva, ask the examiner if you could see the colour fundal picture. In the OSE, you are likely to
be given an enlarged single frame showing characteristic pathology.

The fluorescein angiography may be given as a positive or negative transparency (see picture below). As most
fluorescein angiographies encountered are on positive transparency, all the following interpretations are based
on the apparance on positive tranparency.

aaaaaaaaaa Positive fluorescein angiography Negative fluorescein angiography

The fluorescein angiography is best viewed by placing the transparency on a viewing box and examine the
frames with a 20 D lens (those used for indirect ophthalmoscopy). The frame also contains the time lapsed
from the moment of intravenous fluorescein sodium injection.

Fluorescein angiography can be analysed in the following ways (which complements each other):

Sequential analysis -

it is examined frame by frames in the order that it was photographed. The major vascular
phases of the angiogram is emphasized. This method is most useful in analysing vascular
disorders of the retinal and choroidal.
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Anatomic analysis -

observes each of the major layers of the posterior pose of the eye - the choroidal,
RPE and neurosensory retina.
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Morphologic analysis -

considers overall patterns. In an abnormal angiogram, some areas may be darker

(hyperfluorescent) or lighter (hypofluorescent) than usually in a given location.

In the viva, the examiner would expect you to use the following term while describing the frames
(refer to principles of fluorescein angiography for pictures):

red free: taken before the fluorescein injection

choroidal phase

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arterial phase
capillary phase
venous phase
late phase

Click for part II on interpration of FFA

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