2. FLUORESCENCE :- Property of the certain
molecules to emit light energy of longer wave
length when stimulated by a shorter
wavelength.
Absorbs light in the blue range peaking at
465-490 nm
Emits light of yellow-green range of visible
spectrum peaking at 520-530nm.
3.
4.
5. Diabasic Acid, Yellow Red in color.
Stable, Highly Water Soluble & Pharmacologically
inert.
Low Molecular Weight 376.27 D
Fluoresces at Blood pH
Peak absorption 465 – 490 nm
Peak emission 520 – 530 nm
80% bound to plasma protein and also with RBC
Can’t pass through tight retinal barriers so allows
study of retinal circulation
6. within 24 hours
Mainly –urine ( yellow orange coloration)
Small amount-bile
Some absorbed by kidney
Skin staining may remain up to 24 hours
Urine discoloration –24-36 hours
7. 10 % Solution of 5 ml
25% Solution of 3 ml (for opaque media)
Solution above 25% precipitates.
8. Peripheral vein
venous circulation
heart
arterial system
INTERNAL CAROTID ARTERY
Ophthalmic artery
Short posterior ciliary artery Central retinal Artery
(choroidal circulation) (retinal circulation)
9.
10. Patient is informed of the normal procedures, the side
effects and the adverse reactions.
Dilating the pupil
Made to sit comfortable.
3-4 red free photographs taken.(control
photographs)
11. 5ml of 10% or 3ml of 25% NAF injected through the
anticubital vein
wait for 10 – 12 seconds( normal arm-retina time)
Photos are taken at 1 second interval for 10 seconds
Then every 2 seconds interval for 30 seconds
Late photographs are usually taken after 3 ,5 and 10 minutes
12. Prearterial phase (choroidal phase)
Arterial phase
Arterio -venous phase
Venous phase
early venous
mid venous
late venous
Late phase
13. 10 -12 seconds
Initially patchy filling diffuse filling dye leaks
from choriocapillaris
no dye reaches retinal arteries
Cilioretinal artery if present fills in this phase
20. Gradual elimination of dye from choroidal and the retinal
circulation
Staining of disc :- normal
After 30 seconds of injection first high concentration
flush of fluoroscein begins to empty and Recirculation
phase follows.
Vessels completely empty of fluoroscein in approx
10 minutes.
21. PHASE TIME ( IN Secs)
Injection 0
Choroidal phase 10
Arterial 10-12
Arterio venous 13
Early venous 14-15
Mid venous 16-17
Late venous 18-20
Late ( elimination) 5 MINS
23. HYPERFLUORESCENCE – an area of abnormally
high fluorescence due to increase density of dye
molecule
HYPOFLUORESCENCE - an area of abnormally
poor fluorescence
24.
25. PSEUDOFLUORESCE
NCE
- Non fluorescent light
passes through entire
filter system.
- Decreased contrast
and resolution
Conditions: Any light
colored fundus change
e.g.
Sclera
Scar tissue
Myelinated nerve fibre
Foreign Body
26. innate property of fluorescence in certain
ocular tissue
fluorescence without dye
Optic nerve head drusen & astrocytic
hamartoma
27.
28.
29.
30.
31.
32.
33.
34.
35. Fluorosence of Disc margins from surrounding
capillaries
Fluorosence of lamina cribrosa
Fluorosence of Sclera at disc margin if RPE terminates
away from disc as in Optic crescent
Fluoresence of Sclera if RPE is lightly pigmented.
36.
37.
38.
39.
40.
41. POOLING –
accumulation of dye in closed space e.g. RPE
detachment, CSR
SUB-RETINAL SPACE SUB RPE SPACE
Early hyperfluorescence early hyperfluorescence
increase in size & intensity increase intensity only
e.g. CSR,CNVM e.g. PED
42.
43.
44.
45. Refers to leakage of fluoroscein into tissue or material
Must be contrasted from Pooling
Rule out which tissue involved:
RPE
Bruch’s Memb
Choroid
Sclera
46.
47.
48.
49.
50.
51.
52.
53.
54.
55. Evaluation of vascular integrity of retinal &
choroidal vessels
Disease process affecting macula
Integrity of the Blood Ocular Barrier.
- outer blood retinal barrier breaks in :- CSR
- inner blood retinal barrier breaks in:-NVD ,NVE
56. Determining the extent of damage
Formulating the treatment strategy for retinal
& choroidal disease.
Monitoring the result of treatment.
