ANGIOGRAPHIC

PHASES/ PHASES OF
NORMAL FA
 PHASES OF AN
ANGIOGRAM

1. Early Phase 2. Mid Phase

• Choroidal flush
• Arterial phase 3. Late Phase
• Arteriovenous phase
• Venous phase
 EARLY PHASE
CHOROIDAL FLUSH
In a normal patient, the dye appears
first in the choroid approximately 10
seconds following injection. The major
choroidal vessels are impermeable to
fluorescein, but the choriocapillaris
leaks fluorescein dye freely into the
extravascular space. There is usually
little detail in the choroidal flush as the
retinal pigment epithelium (RPE) acts
as an irregular filter that partially
obscures the view of the choroid.
 EARLY PHASE
ARTERIAL PHASE
The retinal arterioles typically fill one
to two seconds after the choroid;
therefore, the normal "arm-to-retina”
circulation time is approximately 12
seconds. A delay in the arm-to-retina
time may reflect a problem with the
fluorescein dye injection or
circulatory problems with the patient
including heart and peripheral
vascular disease.
 EARLY PHASE
ARTERIOVENOUS PHASE
Complete filling of the retinal
capillary bed follows the arterial
phase and the retinal veins begin to
fill. In the early arteriovenous phase,
thin columns of fluorescein are
visualized along the walls of the
larger veins (laminar flow). These
columns become wider as the entire
lumen fills with dye.
 EARLY PHASE
VENOUS PHASE
Complete filling of the veins
occurs over the next ten seconds
with maximum vessel
fluorescence occurring
approximately 30 seconds after
injection. The perifoveal capillary
network is best visualized in the
peak venous phase of the
angiogram.
 MID PHASE

Also known as the recirculation phase,

this occurs about 2 to 4 minutes after
injection. The veins and
arteries remain roughly equal in
brightness. The intensity of
fluorescence diminishes slowly during
this phase as much of the fluorescein is
removed from the bloodstream on the
first pass through the kidneys.
 LATE PHASE

The late phase demonstrates the

gradual elimination of dye from the
retinal and choroidal vasculature.
Photographs are typically captured 7
to 15 minutes after injection. Late
staining of the optic disc is a normal
finding. Any other areas of late
hyperfluorescence suggest the
presence of an abnormality.
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