Fluorescein angiography (FA) is an ophthalmic test used to assess the blood vessels and blood flow in the retina. At the Eye Microsurgery Center in Chișinău, the test is performed when prescribed by an ophthalmologist.

Duration of the test: approximately 20–30 minutes
Cost: see the current price list
Location: Eye Microsurgery Center, Chișinău

When a Doctor May Recommend FA

Sometimes a standard fundus examination is not enough to determine the cause of changes in vision. Problems with retinal blood flow, abnormal new blood vessels, or areas of fluid leakage may remain undetected during standard diagnostic testing.

In such cases, an ophthalmologist may recommend fluorescein angiography (FA)—a test that provides a detailed assessment of the retinal blood vessels and additional information needed to make a diagnosis and choose the most appropriate treatment.

What Is Fluorescein Angiography?

Fluorescein angiography is a method used to examine the blood vessels of the retina.

During the procedure, a special diagnostic dye called fluorescein is injected into a vein. Within a few seconds, it reaches the blood vessels in the eye, after which the doctor takes a series of photographs of the fundus.

The resulting images make it possible to assess blood flow and detect areas of impaired blood supply, abnormal new blood vessels, sites of fluid leakage, and other changes that may not be visible during a standard examination.

Conditions for Which FA May Be Recommended

FA is used to diagnose and monitor various retinal conditions. The test may be recommended for:

• age-related macular degeneration;
• diabetic retinopathy;
• retinal vascular occlusion;
• central serous chorioretinopathy;
• high myopia with retinal complications;
• retinal vascular diseases;
• suspected abnormal growth of new blood vessels.

FA may also be used to monitor the effectiveness of treatment.

What FA Can Reveal

The test helps the doctor:

• identify changes that cannot be assessed during a standard fundus examination;
• locate areas of impaired blood supply to the retina;
• detect sites of fluid leakage from blood vessels;
• identify abnormally formed blood vessels;
• determine how extensive the retinal changes are;
• assess disease activity;
• choose the most appropriate treatment and monitor treatment outcomes.

How the Test Is Performed

The procedure usually involves several stages:

1. The doctor dilates the pupil using special eye drops.
2. A diagnostic dye called fluorescein is injected into a vein.
3. A series of photographs of the fundus is taken within a few seconds.
4. After the test is complete, the doctor evaluates the images and provides further recommendations if necessary.

Is Any Preparation Required?

No special preparation is usually required.

Before the test, be sure to tell your doctor if:

• you have previously had an allergic reaction to fluorescein or any other medication;
• you are pregnant or think you may be pregnant;
• you are breastfeeding;
• you have any chronic medical conditions;
• you take medication regularly.

After your pupils have been dilated, your vision may remain blurred for some time. It is therefore advisable to arrange for someone to accompany you or to avoid driving until your vision has fully returned to normal.

Can the Test Cause Discomfort?

Most patients tolerate the test well.

When fluorescein is injected, you may briefly feel warm or notice a metallic taste in your mouth. Some patients may experience nausea and, much less commonly, vomiting. These effects usually resolve on their own within a few minutes and do not require treatment.

After the test, your skin may develop a slight yellowish tint, and your urine may become bright yellow or orange. This is caused by the natural elimination of fluorescein from the body and usually resolves within one or two days.

Are There Any Contraindications or Risks?

Fluorescein angiography involves the intravenous injection of a diagnostic dye, so the test has certain contraindications and may cause adverse reactions.

As a rule, FA is not performed in patients who are allergic to fluorescein. The doctor determines on an individual basis whether the test can be performed during pregnancy or in other situations where the potential risks and expected benefits need to be assessed.

In rare cases, allergic reactions of varying severity, including severe reactions, may occur. For this reason, the test is performed in a medical facility where emergency medical care can be provided if necessary.

If you are breastfeeding, be sure to tell your doctor before the test. If necessary, the doctor will provide individual recommendations regarding breastfeeding after the procedure.

Frequently Asked Questions

Is FA Painful?

The procedure itself is usually painless. Any discomfort is usually related to the intravenous injection.

Can FA Be Replaced by Another Test?

In some cases, the doctor may recommend optical coherence tomography angiography (OCTA), a test that examines the retinal blood vessels without the intravenous injection of a dye.

FA and OCTA provide different diagnostic information and cannot always replace one another. The ophthalmologist will determine which test is appropriate in each case after examining the patient and assessing the condition of the retina.

When Will the Results Be Ready?

In many cases, the doctor can make a preliminary assessment of the images immediately after the test. The patient receives the final report and further recommendations once the results have been reviewed by the ophthalmologist.

Why Does a Doctor Decide Whether FA Is Necessary?

FA is not recommended for every patient. The decision depends on the condition of the retina, the examination findings, and the additional diagnostic information the doctor needs to obtain.