Fig. Retinal pigment epithelium (RPE) which composed from monolayer of cells & its functions are: Absorption of scattered light, Control of fluid and nutrients in the subretinal space (blood retinal Barrier function), visual pigment regeneration and synthesis.1 Synthesis of growth factors to modulate adjacent structures maintenance of retinal adhesion phagocytosis and digestion of photoreceptor wastes electrical homeostasis. Read reviews from world’s largest community for readers. Before we discuss the fluorescein angiography in details we must give brief anatomy of the retina and choroid. By Amresh Chopdar. Blocking: Blood or other opacities block the fluorescence. Ophthalmologist Yazan Zahran eye clinic Jordan, Correspondence: Yazan zahran Ophthalmologist Yazan Zahran eye clinic 9 Suliman adeedi street Amman Po Box 143539 Jordan, Tel 962790573036, Received: September 27, 2014 | Published: June 8, 2015, Citation: Zahran Y. Transmission defect (window defect): (Figure 17) A window defect refers to the choroidal fluorescence produced by a relative decrease or absence of pigment in the RPE or an absence of RPE. 1, 6 The landmark text Atlas of Macular Diseases by Dr J. Donald Gass set a new standard for the use of stereoscopic fluorescein angiography in fundus diagnosis. Fluorescein angiography finds its origins in the late 1960s with the publication of an original article describing its use as well as subsequent atlases and textbooks for a medical retinal specialty in its infancy. Arterial phase: (Figure 7) Starts 1 to 3 seconds after choroidal fluorescence with filling of the central retinal artery after the central retinal artery begins to fill, the dye flows into the retinal arterioles, pre capillary arterioles, the capillaries, the post capillary venules, and finally the retinal veins. Since the technique was first described, less than 20 years ago, a tremendous amount of angiographic data has been accumulated, which has had a revolutionary impact on the understanding of fundus disease. Figure 4 Pigmented monolayer the retinal pigment epithelium (RPE). ICG fluoresces in the infrared wavelength and readily passes through the RPE (retinal pigment epithelium). High Yield Knowledge for the Ophthalmology Trainee. Step-By-Step Fundus Photography and Fluorescein Angiography. … Outer retinal barrier: consists of tight junctions between the retinal pigment epithelium (RPE) 2. In contrast with FA, indocyanine green (ICG) dye is great for evaluating the choroidal circulation. How to read fluorescein angiography 132 Copyriht: 215 ahran Citation: Zahran Y. Interpretation of fundus fluorescein angiography [Schatz, Howard, etc., Schatz, H., Burton, T.C., Yannuzzi, L.A., Rabb, M.F.] Atlas Of Fundus Fluorescein Angiography book. Pooling: Hyperfluorescence progressively enlarges to fill the fluid cavity and then, Staining: Late hyperfluorescence due to accumulation of fluorescein dye. Venous phase: Complete filling of the veins. Oxford: Butterworth-Heinemann, 1996. Sodium fluorescein is orange in color, it’s molecular weight of 376. Mainly from posterior ciliary arteries. Figure 11 Recirculation phase & late phase. Figure 13B Visualization fluorescein blocked by Blood. Some common conditions for which fluorescein angiography is indicated include atrophic macular degeneration, central serous chorioretinopathy, cystoid macular edema, ischemic optic neuropathy and malignant choroidal melanoma. There are 4 types of hyperfluorescence (brightness) in FA: There are 2 major types of hypofluorescence: Our site is most compatible with Chrome, Firefox, or Safari. Blue light (wavelength 465-490 nm) is then absorbed by unbound fluorescein molecules, and the molecules fluoresce, emitting light with a longer wavelength in the yellow-green spectrum (520-… Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. What does the word mean? This makes FA good for evaluating the retinal vasculature, not the choroidal vasculature. The ocular fundus has two separate vascular systems-retinal and choroidal-separated by a specialized pigmented monolayer the retinal pigment epithelium (RPE) (Figure 3) (Figure 4). Nowadays, OCT has greatly reduced the number of FAs performed, though FA still remains a very important modality for assessing many circulatory dysfunctions of the retina. £72.50. The borders of hyper fluorescence become increasingly blurred, & the greatest intensity of the hyper fluorescence is appreciated in the late phases of the study pooling: (Figure 19) (Figure 20) Pooling refers to the accumulation of fluorescein dye into an anatomical space. Fluorescein is a … Staining: (Figure 21) Staining results from fluorescein entry into a solid tissue such as a scar, optic nerve tissue, or sclera the pattern of hyper fluorescence with gradually increasing intensity of fluorescence, but the borders of the hyper fluorescence remain fixed throughout the angiogram process. Fluorescein angiographic patterns reveal a wide variety of anatomical, pathological and physiological information which, correctly interpreted, contributes to the differential diagnosis of fundus diseases and to the evaluation of appropriate therapeutic approaches. Please switch to one of those browsers if available. 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