“Fluorescein angiography is an important test to study the retina (or “film”) at the back of your eye. It is used to diagnose certain eye conditions and to guide treatment. It is commonly performed in diabetic retinopathy, age-related macular degeneration and diseases affecting the blood vessels in your eye.”
“Fluorescein angiography uses a dye to take special photos of the back of your eye (retina)”.
“This is a commonly performed and generally safe procedure, but as with any medical procedure, complications can occur”:
Optical coherence tomography-Angiography (OCT-A), OCT, indocyanine green angiography (ICG) and fundus autofluorescence may offer complementary information.
NB: Renal failure is not a contraindication to fluorescein angiography.
“An intravitreal injection is an injection into the jelly inside the eye called the vitreous. This delivers medication to the retina at the back of the eye. It is a commonly performed procedure used to treat a number of conditions including age-related macular degeneration, diabetic retinopathy, inflammation in the eye and diseases affecting the blood vessels in the retina.”
“There are two forms of macular degeneration: wet and dry. You have the wet form where abnormal blood vessels grow underneath the retina causing bleeding that blurs your vision. We now have drugs that when injected in the vitreous can stop the growth of these vessels and reduce the bleeding. Most patients will notice an improvement in their vision. You are likely to require a number of treatments, initially monthly.”
“Medication will be given into your eye as an injection”
Most patients tolerate the injection very well.
Serious complications occur rarely (<0.1%):
Any of these complications can lead to severe permanent loss of vision.
Astigmatism is common
May need glasses/contact lenses/another operation
Takes time for good vision
A) Anti-VEGF Injections
B) Intravitreal Steroid Injections
“You have swelling at the back of your eye (“retina”) due to leaking blood vessels from diabetes / vein occlusion. This swelling is causing a reduction in your vision (“wet camera film” analogy)”.
Although macular laser has a good success rate, complications may occur:
Stress close follow-up, need for urgent review if vision declines.
“You have advanced damage to the back of your eye (“retina”) from diabetes. This has resulted in the growth of abnormal blood vessels in the retina. If left untreated these blood vessels can bleed (reducing your vision) or cause scarring and retinal detachment.”
This is the mainstay of treatment for proliferative “severe” diabetic retinopathy and has been demonstrated to reduce the risk of severe vision loss by 50% (Diabetic Retinopathy Study DRS).
“Laser targeting the peripheral part of the back of your eye (“retina”) is required to prevent bleeding and preserve your central vision.”
“Although PRP has a good success rate, complications may occur:”
Pain / Discomfort
Can have peribulbar anaesthetic if unable to tolerate
↓ Peripheral / Night vision
↓ Night Vision (Nyctalopia)
Loss of Near Vision
Reduced accommodation in pre-presbyopic patients
Uncommon (worsening of macular oedema, inadvertent foveal burn, CNV)
Stress close follow-up, need for urgent review if develops reduced vision.
“You have an abnormal blood vessel or vessels in the back of your eye that could result in long term vision loss without treatment. This treatment helps to seal off those abnormal blood vessels.”
PDT can be used for central serous chorioretinopathy (CSC) as well as certain types of wet age-related macular degeneration (polypoidal choroidal vasculopathy).
Aim: Stop further leaking and stabilise vision, may improve vision in some cases.
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Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.