Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study.
OBJECTIVE
To evaluate allergy skin testing as a diagnostic tool of adverse reactions to fluorescein and whether allergy and previous sodium fluorescein angiography (SFA) act as predisposing factors.


METHODS
Patients with adequate indication for fluorescein angiography and normal skin responsiveness were subjected to allergy skin-prick and intradermal tests for fluorescein, followed by SFA. During SFA, adverse reactions were monitored and classified as mild, moderate or severe. Previous SFAs and adverse reactions as well as the presence of atopy were also registered.


RESULTS
One thousand and thirty-seven patients were enrolled in the study and 1284 SFAs were executed. Forty-four patients (4.3%) developed 55 adverse reactions; among them 50 (3.8%) were mild, three (0.2%) moderate and two (0.16%) severe. None of the reactors produced positive skin tests to fluorescein. Patients with atopy and previous SFAs were not more susceptible to adverse reactions.


CONCLUSIONS
The vast majority of adverse reactions to fluorescein are mild and not attributed to immunological mechanisms. Allergy skin tests cannot predict non-immunological reactions but their utility remains substantial in predicting anaphylaxis during SFAs and must be performed in patients reporting risk factors in their past medical history.
Kalogeromitros
Dimitrios C
DC
Allergy Clinical Research Centre, Allergy Unit, 2nd Department of Dermatology and Venereology, Attikon University Hospital, University of Athens, Greece.
Makris
Michael P
MP
Aggelides
Xenophon S
XS
Mellios
Anagnostis I
AI
Giannoula
Fani C
FC
Sideri
Kyriaki A
KA
Rouvas
Alexander A
AA
Theodossiadis
Panagiotis G
PG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D019793:Fluorescein / Q000009:adverse effects*; D005451:Fluorescein Angiography; D005456:Fluorescent Dyes / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests / Q000379:methods*; D055815:Young Adult
D005456:Fluorescent Dyes; D019793:Fluorescein