Fluorescein Angiography: General Principles and Interpretation

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Since its first use as a diagnostic tool in the 1960s, fluorescein angiography has become an invaluable and increasingly sophisticated tool for studying, understanding, documenting, and treating ocular disease. The unique optical properties of the eye make the ocular fundus the only location in the human body where direct noninvasive monitoring of vascular flow is possible.1 During fluorescein angiography, a rapid sequence of serial photographs is taken after the administration of intravenous fluorescein to visualize and document choroidal and retinal blood flow. Beyond blood flow, fluorescein angiography provides information about the integrity of the blood—retinal barrier, the fine details of the retinal pigment epithelium (RPE), and a glimpse of associated systemic pathology.2 These properties have made fluorescein angiography one of the most useful office-based diagnostic tools in ophthalmology for the last 30 years.3 In fact, the advent of angiography can be considered to have ushered in a new era in the subspecialty of ophthalmology: vitreoretinal surgery.4