Oral fluorescein angiography with the confocal scanning laser ophthalmoscope.
OBJECTIVE
To evaluate the efficacy of oral fluorescein angiography with a confocal scanning laser ophthalmoscope (SLO) system.


METHODS
Comparative case series.


METHODS
The authors used a confocal SLO (Heidelberg Retina Angiograph [HRA]) to perform oral fluorescein angiography in 47 patients, 13 of whom were without any retinal disease and 34 with a variety of retinal diseases including macular holes and pucker, inflammatory diseases, retinal vascular diseases, and age-related macular degeneration. The images were also compared to images taken with a fundus camera after intravenous fluorescein injections in patients on whom both studies were done.


METHODS
Color fundus photographs were taken of each eye (30 degrees fundus camera) before drinking 4 ml of 25% sodium fluorescein mixed with 60 ml of orange juice. After oral fluorescein ingestion, images of each eye were taken with a fundus camera (TriX film) and the HRA (using 512- x 512-pixel resolution). The images were repeated at 0-, 2.5-, 5-, 7.5-, 10-, 12.5-, 15-, 20-, 25-, and 30-minute intervals. Twenty of the 47 patients underwent intravenous fluorescein angiography performed with the fundus camera.


METHODS
Images were analyzed by a masked reader, and foveal avascular zone visualization, branch retinal vessel identification, and image quality were scored. Statistical analysis was performed with a t test for paired data with a two-tailed test of significance (alpha = 0.05).


RESULTS
Foveal avascular zone was 100% as seen in 16 eyes (47%) in the HRA machine versus 1 eye (2%) in the conventional fundus camera (P < 0.0001). The third-order branch retinal vessels were identified in 59% of eyes in the HRA versus 26% in the fundus camera group (P < 0.0001), and the image quality was considered comparable to an intravenous angiogram in 47% with the HRA versus 9% with the conventional fundus camera (P < 0.0001).


CONCLUSIONS
Oral fluorescein angiography using the HRA produces sufficiently detailed images to diagnose, treat, and follow many types of retinal pathology.
Garcia
C R
CR
University of California, San Diego, Department of Ophthalmology, Shiley Eye Center, La Jolla 92093-0946, USA.
Rivero
M E
ME
Bartsch
D U
DU
Ishiko
S
S
Takamiya
A
A
Fukui
K
K
Hirokawa
H
H
Clark
T
T
Yoshida
A
A
Freeman
W R
WR
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019793:Fluorescein / Q000008:administration & dosage*; D005451:Fluorescein Angiography / Q000295:instrumentation / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D007275:Injections, Intravenous; D007834:Lasers; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D019721:Ophthalmoscopes; D010781:Photography; D012164:Retinal Diseases / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*
D019793:Fluorescein