title: Safety and efficacy of oral fluorescein angiography in detecting macular edema in comparison with spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To evaluate the safety of oral fluorescein angiography (FA) and to compare its efficacy in detection of macular edema (ME) with spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  Results of imaging studies for 1,928 eyes of 1,019 patients who had simultaneously undergone both oral FA and SD-OCT by a confocal laser ophthalmoscope were reviewed. Sensitivity in detecting ME, discrepancy rate, and "kappa" agreement were determined for both the techniques and with eyes stratified by disease diagnosis.
  
  
  RESULTS
  No allergic reactions occurred after oral FA. Mild gastric discomfort was noted in <1% of the patients; 1,840 eyes (95.4%) showed concordance between the two techniques, and kappa agreement was 90.3%. For ME, oral FA showed an overall sensitivity of 0.97 and SD-OCT of 0.91. Equivalent sensitivity was found in cases of wet age-related macular degeneration (0.99). Oral FA was more sensitive than SD-OCT in cases of retinovascular diseases. The SD-OCT showed higher sensitivity in cases of macular holes. Detection of ME by SD-OCT was significantly higher in cases of intense leakage on oral FA (P < 0.001).
  
  
  CONCLUSIONS
  Oral FA proved to be a safe and an adequate technique to evaluate ME. It is more sensitive than SD-OCT in detection of ME in cases of retinovascular diseases but can fail to detect ME in cases of macular holes. A noninvasive examination with simultaneous oral FA and SD-OCT may be considered to obtain a comprehensive evaluation of the presence of ME from different pathologies.
authors.affiliation: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California San Diego, La Jolla, CA, USA.
authors.forename: Giulio
authors.initials: G
authors.lastname: Barteselli
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
authors.forename: Su Na
authors.initials: SN
authors.lastname: Lee
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
authors.forename: Sharif
authors.initials: S
authors.lastname: El Emam
authors.forename: Igor
authors.initials: I
authors.lastname: Kozak
authors.forename: Lingyun
authors.initials: L
authors.lastname: Cheng
authors.forename: Dirk-Uwe
authors.initials: DU
authors.lastname: Bartsch
authors.forename: Stanley
authors.initials: S
authors.lastname: Azen
authors.forename: William R
authors.initials: WR
authors.lastname: Freeman
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D019793:Fluorescein / Q000008:administration & dosage / Q000009:adverse effects; D005451:Fluorescein Angiography / Q000379:methods*; D005456:Fluorescent Dyes / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009887:Ophthalmoscopy; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein