Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Dr Rajvin Samuel
Fluorescein
`
 Fluorescein is a synthetic organic
compound available as a dark
orange/red powder soluble in water
and alcohol.
 Synthesis:
It can be prepared from phthalic
anhydride and resorcinol in the
presence of zinc chloride via
the Friedel-Cr...
Medical applications :
 In forensics and serology to detect latent blood stains
 In Microbiology –To detect Leptospira s...
 Fluorescein sodium is used extensively as a
diagnostic tool in the field of ophthalmology. It
is applied topically in th...
In ophthalmology
 Ophthalmic research :
Intraocular dynamic studies [fluorometry]
Tear film drainage studies
Penetration ...
Fluorescein angiography
 Photographic surveillance of passage of fluorescein
through retinal and choroidal circulation
 ...
 80 % protein bound and 20 % free into circulation
 PROCEDURE:
White light from camera flash pass through
blue excitatio...
 Phases : 1 . Choroidal
2. Arterial
3. Arteriovenous [capillary]
4. Venous
5. Late [elimination]
Side effects of Fluoresc...
 Hypofluorescence: 1. Vascular filling defects
2.Blockage by haemorrhage
RPE hypertrophy ,Hard -
- exudates, Naevi ,….
 ...
Staining Techniques:
 Seidel’s test for Wound leak
 Corneal Staining for ulcers ,other epithelial
defects
Test for dry eye
 Tear break up time
To test for tear film stability ,fluorescein dye is added to
the
eye and the tear fi...
Tests for lacrimal drainage
 Jones dye test :
To distinguish between Anatomical and functional
outflow problems
 Instil ...
 No fluorescein - Negative Primary Jones Test
and the functional obstruction could be anywhere
from the punctum to the Va...
Applanation tonometry
 The intraocular pressure is inferred from the
force required to flatten (applanate) a
constant are...
 4. Dial is rotated to align inner margins of
semicircles to just touch each other
 5.Reading on dial multiplied by 10 =...
THANK YOU
Fluorescein in Ophthalmology
Upcoming SlideShare
Loading in …5
×

Fluorescein in Ophthalmology

13,867 views

Published on

Published in: Health & Medicine
  • http://pgprogramme.blogspot.in/2014/10/fundus-fluorescin-angiography.html
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Fluorescein in Ophthalmology

  1. 1. Dr Rajvin Samuel Fluorescein
  2. 2. `  Fluorescein is a synthetic organic compound available as a dark orange/red powder soluble in water and alcohol.
  3. 3.  Synthesis: It can be prepared from phthalic anhydride and resorcinol in the presence of zinc chloride via the Friedel-Crafts reaction.  Other name - Resorcinolphthalein
  4. 4. Medical applications :  In forensics and serology to detect latent blood stains  In Microbiology –To detect Leptospira strains under microscopy in Syphilis Serology (FTA-ABS Test)  In dentistry - a dye applied to teeth to reveal plaque
  5. 5.  Fluorescein sodium is used extensively as a diagnostic tool in the field of ophthalmology. It is applied topically in the form of a drop or it can be injected intravenously to produce a fluorescein angiogram.  Topical fluorescein is useful in the diagnosis of corneal abrasions, corneal ulcers, herpetic corneal infections, and dry eye. Fluorescein angiography is used to diagnose and categorize macular degeneration, diabetic retinopathy, inflammatory intraocular conditions, and intraocular tumors
  6. 6. In ophthalmology  Ophthalmic research : Intraocular dynamic studies [fluorometry] Tear film drainage studies Penetration to anterior segment structures  Fluorescein angiography [in acquired macular & Retinal vascular patholgies]  Staining techniques  Test for dry eye  Evaluation of tear drainage  Applanation tonometry
  7. 7. Fluorescein angiography  Photographic surveillance of passage of fluorescein through retinal and choroidal circulation  Principle: A molecule is excited by light of certain wavelength to a higher energy level ,release photon then comes down to original state 2 ml of 25 % [0r] 5 ml of 10 % solution
  8. 8.  80 % protein bound and 20 % free into circulation  PROCEDURE: White light from camera flash pass through blue excitation filter [488 nm ] stimulates Yellow – green barrier filter [533 nm] back into camera film A red free photograph is taken at 1 second interval 5-25 secs after injection onset
  9. 9.  Phases : 1 . Choroidal 2. Arterial 3. Arteriovenous [capillary] 4. Venous 5. Late [elimination] Side effects of Fluorescein: Temporary yellowing , Orange yellow urine , Nausea,vomiting ,Urticaria , Toxic neuritis ,Local tissue necrosis ,Extravasation into skin ,vasovagal reactions
  10. 10.  Hypofluorescence: 1. Vascular filling defects 2.Blockage by haemorrhage RPE hypertrophy ,Hard - - exudates, Naevi ,….  Hyperfluorescence: Leakage Pooling staining Transmission [window defect]
  11. 11. Staining Techniques:  Seidel’s test for Wound leak  Corneal Staining for ulcers ,other epithelial defects
  12. 12. Test for dry eye  Tear break up time To test for tear film stability ,fluorescein dye is added to the eye and the tear film is observed under the slit lamp while the patient avoids blinking until tiny dry spots develop. The longer it takes, the more stable the tear film. A short tear break-up time is a sign of a poor tear film. Generally, >10 seconds is thought to be normal, 5 to 10 seconds, marginal, and <5 seconds low
  13. 13. Tests for lacrimal drainage  Jones dye test : To distinguish between Anatomical and functional outflow problems  Instil one drop of fluorescein into the conjunctival sac  Put a cotton bud soaked in anaesthetic in the inferior meatus.  If fluorescein is detected after five minutes, the system is patent (positive Primary Jones Test).
  14. 14.  No fluorescein - Negative Primary Jones Test and the functional obstruction could be anywhere from the punctum to the Valve of Hasner.  Next, wash the excess fluorescein from the conjunctival sac and syringe. Fluorescein detected, entered the sac - positive Secondary Jones Test and functional obstruction of the nasolacrimal duct.  If No dye after syringing, negative Secondary Jones Test, because fluorescein not entered the sac and, thus, there is stenosis of the puncta or canalicular system - Anatomical obstruction.
  15. 15. Applanation tonometry  The intraocular pressure is inferred from the force required to flatten (applanate) a constant area of the cornea, as per the Imbert-Fick law.  1.Anaesthetic & fluorescein instilled in conjuntival sac  2.With Cobalt blue filter,brightest illumination and prism advanced until touches apex of cornea  3.A pattern of 2 semicircles one above ,other below the horizontal midline
  16. 16.  4. Dial is rotated to align inner margins of semicircles to just touch each other  5.Reading on dial multiplied by 10 = Intraocular pressure
  17. 17. THANK YOU

×