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Identifying the factors for improving quality of oral fluorescein angiography

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Amador-Patarroyo, Manuel J
Lin, Tiezhu
Meshi, Amit
Dans, Kunny C
Chen, Kevin
Borooah, Shyamanga
Molano González, Nicolás
Díaz-Rojas, Jorge A
Freeman, William R



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BMJ Publishing Group

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Aim To evaluate the quality of oral fluorescein angiography (FA) in relation to food intake. Methods This is an observational, case-crossover study. We collected information from patients undergoing routine oral FA for retinal disease at the Shiley Eye Institute. Eighty patients (160 eyes) were analysed. Fasting and non-fasting images of the same patient were recorded, compared and analysed for different image quality parameters and clinical relevance by experienced retina specialists. Results When analysing the images, intergrader agreement was moderate to good with a Kappa averaging 0.60 (0.5-0.85). When patients were fasting pre-imaging, better angiography quality scores were achieved when compared with images taken when patients were non-fasting (mean 0.84 vs 0.72, p less than 0.001). Multivariate analysis showed that non-fasting patients with higher body mass index had the worst scores. Other clinical parameters, such as staining of drusen, staining of disciform scars or central and peripapillary atrophy, were also significantly better during the pre-fasting exam (p less than 0.001). Oral FA was approximately 22% faster (time to fluorescein dye appearance) under fasting conditions than non-fasting (mean±SD, minutes, 18.7±6.9 vs 25.14±8.1, p less than 0.001). Conclusion Fasting oral FA provided significantly better quality images as well as faster optimal imaging times when compared with non-fasting oral FA. By improving its overall quality, oral FA could be a useful adjunctive examination to optical coherence tomography (OCT) and OCT angiography in patients who require FA studies but who have difficult access or refuse an invasive procedure. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Palabras clave
Dye , Aged , Article , Body mass , Cross-sectional study , Fasting , Female , Fluorescence angiography , Food intake , Human , Image analysis , Image quality , Macular degeneration , Major clinical study , Male , Medical specialist , Observational study , Patient safety , Personal experience , Priority journal , Retina disease , Scoring system , Staining , Diagnostic tests/investigation , Imaging , Macula , Pharmacology , Physiology
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