What is a fundus fluorescein angiography?

Fundus fluorescein angiography (or FFA) is an investigation of the back of your eye (retina/fundus) that is done using an orange fluorescein dye that is injected into your vein. This investigation is done to capture and highlight circulation issues such as leaking or blocked blood vessels in your eye and help to diagnose and follow retinal conditions.

How is an FFA investigation done?

First, your ophthalmologist and our anesthesiologist will assess your eligibility for FFA, including any allergies you may have or previous reactions to fluorescein dye. It is extremely important that you mention any previous reaction. If you are suitable, you will be asked to sign a consent form and your pupils will be dilated (contact lenses will need to be removed). An orange fluorescein dye is then injected into a vein in your arm with a needle (like a blood test). As the dye travels to the blood vessels in the back of your eye (this only takes seconds), photographs are taken in rapid succession. During the investigation, you should be as still as possible while the photographs are being taken. The investigation takes about 15 minutes.

What are the risks and side effects?

If you feel unwell at any point during the investigation, do not hesitate to inform the nurse or ophthalmologist (you will be accompanied by them throughout the procedure). It is quite common to feel slightly nauseous during the investigation, but usually this will pass within a few seconds. Taking deep breaths helps. Some patients may feel the need to vomit. Itchy, tingly skin or a rash can occur, which may be relieved by antihistamines if needed. Due to the orange dye, your skin and urine will turn yellow for 1-2 days, which is completely normal. Drinking plenty of water after the investigation will help to flush out the dye. A small bruise may be visible at the site of the injection for a few days. If the dye is injected into the tissue outside the vein (due to needle displacement, movement, leakage, etc.), a burning sensation may be felt. If this happens, the investigation will be stopped and the burning will subside within a few days. A severe allergic reaction (anaphylaxis) to the dye itself is a serious but very rare side effect that can cause breathing or circulation difficulties. Finland Eye Center is fully equipped to manage such a situation. In the event of a side effect or poor cooperation by the patient (e.g. patient moving, blinking too much, etc.), it may be necessary to pause or stop the investigation and another session may be required or the FFA may need to be forgone altogether.

What if I do not want to do the investigation?

9 Color fundus img(a), early flurescein angiogram (b) and late fluorescein angiogram (c)

Your ophthalmologist will explain why you are advised to do an FFA investigation. Should you wish to not undergo the procedure or you are found to be unsuitable for it (such as a previous allergic reaction), you will be explained alternative investigations (if possible) and the consequences of relying on the alternatives instead. It is important to understand that certain conditions can only be diagnosed definitively and followed reliably depending on the results of an FFA, but of course it is your right to refuse the procedure. 

What happens after the FFA procedure?

You will be asked to stay a while after your FFA investigation to ensure you are feeling well. Your ophthalmologist will review the findings and discuss them with you either soon after the investigation or at a separate appointment. It is advisable to bring sunglasses or a hat since your dilated pupils will make your eyes sensitive to light. For this reason and in case you are experiencing side effects, we recommend you have someone to take you home.

Note :

You should tell your doctor if you are pregnant or you have past history of allergic reaction asthma or renal failure.

Breastfeeding should be stopped for 48 hours after procedure.