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Eye Angiogram

Test Overview

An eye angiogram uses fluorescein dye and a camera to take pictures and evaluate the blood flow through the vessels in the back of the eye. An eye angiogram is a type of retinal imaging test.

Unlike other angiogram procedures, an eye angiogram is not an X-ray procedure, so you are not exposed to any radiation.

Why It Is Done

An eye angiogram helps eye doctors diagnose and manage the treatment of retinal diseases that may be the cause of poor vision. For example, the test may be done to:

  • Confirm the presence of abnormal blood vessels in or under the retina.
  • Check for and locate leaking blood vessels in the retina, especially if you have symptoms that suggest damage to or swelling of the retina, such as blurred or distorted vision. This is often caused by diabetic retinopathy or macular degeneration.
  • Help find inflammation or tumors in the eye.
  • Locate the precise areas of the retina that need treatment prior to laser eye surgery.
  • Help find blockage in the blood vessels that feed or drain blood from the retina (retinal arteries and veins).

How To Prepare

If you wear contact lenses, remove them before the test. After the test, do not put soft contact lenses back in your eyes for at least 4 hours because the contacts may become stained from the dye used for the test.

Before the test, tell your doctor if you:

  • Have ever had an allergic reaction to X-ray contrast materials, iodine (which is present in indocyanine green dye), fluorescein, or dilating eyedrops.
  • Have a history of glaucoma, including closed-angle glaucoma. You may need to delay doses of certain eyedrops until after the test. The doctor also may not use dilating eyedrops or may use different eyedrops before the test.
  • Are taking any prescription or over-the-counter medicines.
  • Are or might be pregnant or are breast-feeding. Most doctors discourage the use of this test during pregnancy, especially during the first 3 months, and while a woman is breast-feeding.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information formmedical test information form(What is a PDF document?).

After the test:

  • Your vision may be blurred for up to 12 hours.
  • You should not drive until the effects of the dilating eyedrops wear off. Arrange for someone to drive you home.
  • You should wear sunglasses until your pupils return to normal size. Bright light and sunshine may hurt your eyes.

How It Is Done

An eye angiogram is done in a hospital or doctor's office by an ophthalmologist.

Before the test, the doctor uses drops to widen, or dilate, your pupils. You will be seated in a chair facing the camera. You should loosen or remove any restrictive clothing around your neck. You will be asked to place your chin on a chin rest and your forehead against a bar to stabilize your head. Keep your mouth closed, open your eyes as widely as you can, and stare straight ahead while breathing and blinking normally. A few photographs will be taken.

An IV needle is then placed in a vein in your arm and the dye is injected. Once injected, it takes about 10 to 15 seconds for the dye to be visible in the blood vessels in your eyes.

As the dye enters the eyes, the doctor takes a rapid series of photos. The photos show the dye's progress through the blood vessels in your eyes. The dye makes the blood vessels show up clearly in the photos. More photos are taken after most of the dye has passed through the eyes to see whether any of the blood vessels are leaking the dye. If dye leaks out of a blood vessel, it will color the surrounding tissue and fluid in the eye.

The test usually takes about 30 minutes, unless additional photos are needed. If more photos are needed, you will rest for 20 minutes before 5 to 10 more photos are taken. Photos can be taken up to 1 hour after an injection.

How It Feels

When fluorescein dye is injected into your arm, you may notice a metallic taste in your mouth, mild nausea, and a brief sensation of warmth.

After the test, your skin, the whites of your eyes, and your urine may be bright yellow or orange, but these effects wear off in 24 to 48 hours.

Because of the dilating eyedrops, your vision may be blurred, and your eyes may be sensitive to light for up to 12 hours.

Risks

While the fluorescein dye is injected, you may become nauseated and feel flushed. These symptoms pass quickly.

Some people are allergic to the dye. Tell your doctor if you feel lightheaded, need to vomit, or feel itchy after the dye is injected. Very rarely, a person may have a serious allergic reaction (anaphylaxis) and need emergency care.

Dye that leaks out of the vein around the injection site may cause pain and may injure the skin.

The dye may pose a risk to a fetus. If you are pregnant, talk to your doctor about these risks.

Results

An eye angiogram uses fluorescein or indocyanine dye and a camera to take pictures and evaluate the blood flow through the vessels in the back of the eye (retina).

This test takes about 30 minutes. Your doctor can usually review the results soon after.

Eye angiogram
Normal:
  • The dye flows through the blood vessels in the retina without delays.
  • There are no leaks or areas of blockages.
Abnormal:
  • The dye flows very slowly through the blood vessels.
  • The flow of dye is blocked.
  • The dye leaks from the blood vessels.
  • The dye pools in the surrounding eye tissue or in the optic disc.

Many conditions can change eye angiogram results. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Cataracts.
  • Inadequate dilation of the pupils.
  • Inability to keep your eyes wide open and to stare straight ahead during the test.
  • Inability to hold still during the test.

What To Think About

  • Since the dye passes to your baby in breast milk, it is not safe for women to breast-feed for 24 to 48 hours after this test. Use a breast pump to empty your breasts and discard the milk until it is safe to start breast-feeding again. You may wish to collect and store breast milk for several days before the test or purchase formula to use during this time.
  • A dye called indocyanine green is better at finding some types of eye problems and may be used instead of fluorescein. After the dye is injected into your vein, your eye doctor uses infrared light to see whether blood vessels underneath the retina are leaking. This type of retinal imaging test is called indocyanine green angiography.
  • Your eye doctor may also use optical coherence tomography (OCT) to look for problems with the retina. You don't need an injection for this type of retinal imaging.

References

Other Works Consulted

  • Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Prall FR, et al. (2009). Fluorescein angiography, indocyanine green angiography, and optical coherence tomography. In M Yanoff, JS Duker, eds., Ophthalmology, 3rd ed., pp. 536–544. Edinburgh: Mosby.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
Last Revised May 29, 2013

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