Fig. 1. The frequency of adverse reactions (vomiting and nausea, skin
allergies, and unconsciousness) is shown in Figure 1.
There was no statistically significant difference in the adverse events
between those who fasted vs those who didn’t before the procedure
(P>0.05).
Discussion:
Intravenous fluorescein angiography is increasingly being used to
diagnose different retinal conditions [7]. The overall complication
rate for the fasting group was 12.49% compared to 14.15% in the
non-fasting group. it is to be noted that the difference in the
complication is due to the difference in mild complication in these two
populations while the moderate and severe complication in these two
populations is not clinically significant. According to Oliver R.
Marmoy, Robert H. Henderson, and Kuan Ooi, a patient who has had only a
light breakfast without lunch before the oral FFA procedure is more
effective and safer [8].
Also, when we compare the complication rate in patient with systemic
disease (diabetics, hypertension) the mild, moderate, and severe
complication is 8.49%, 0.94%, and nil respectively in the
population(n=73) who had breakfast immediately before the procedure
while the population (n=59) who has undergone FFA in the empty stomach
has the mild, moderate and severe complication of 3.92%, 0.98%, 0.98%
respectively. Here also the mild complication rate is higher in patients
who had breakfast before the procedure, while the moderate to severe
complication rate is clinically insignificant. Fayyaz Musa,1 Wisam J.
Muen found no Adverse effects of fluorescein angiography in hypertensive
and elderly patients, [9]
Since the mild complication in these two populations has nausea and
vomiting only and is temporary, it is safe to perform FFA in patients
who had a light breakfast before the procedure. Also, a history of any
systemic disease which is under control with medications has comparable
adverse effects in these two populations.
Conclusions:
We conclude that FFA is a relatively safe procedure that yields
important diagnostic information which might ultimately have a positive
impact on the patient’s quality of life. FFA should not be postponed on
the basis of whether the patient was empty stomach or not. Systemic
illness as these factors, not adverse reactions in FFA procedures both
groups had complication rate are same which is not clinically
significant in this study.
Conflicts of interest:
The authors have no conflict of interest.
REFERENCES:
1. Ali SM, Kozak I. Fundus fluorescein angiography via percutaneous
endoscopic gastrostomy: Description of technique. Am J Ophthalmol Case
Rep. 2023 Jun 1;30.
2. Littlewood R, Mollan SP, Pepper IM, Hickman SJ. The Utility of Fundus
Fluorescein Angiography in Neuro-Ophthalmology. Vol. 43,
Neuro-Ophthalmology. Taylor and Francis Ltd; 2019. p. 217–34.
3. Bennett TJ, Quillen DA. Fundamentals of Fluorescein Angiography
[Internet]. Available from:
www.eye-pix.com.
4. Tsang SH, Sharma T. Fluorescein Angiography. Adv Exp Med Biol. 2018;
1085:7–10.
5. Muhammad Farooq Hyderi, Tariq Pervaiz Khan. Incidence of
Complications during Fluorescein Fundus Angiography (FFA)in Our
Population
6. Beleña JM, Núñez M, Rodríguez M. Adverse Reactions Due to Fluorescein
during Retinal Angiography. Vol. 1, JSM Ophthalmol. 2013.
7. Dr. (Prof.) Sanjeev K Nainiwal, MD, DNB, Dr. Indra Dandaliya. Study
by Fundus Fluorescein Angiography as a Diagnostic Tool in Various
Retinal and Choroidal Disorders Department of Ophthalmology, JLN Medical
College, Ajmer-305001, Rajasthan, INDIA.
8. Marmoy OR, Henderson RH, Ooi K. Recommended protocol for performing
oral fundus fluorescein angiography (FFA) in children. Vol. 36, Eye
(Basingstoke). Springer Nature; 2022. p. 234–6.
9. Musa F, Muen WJ, Hancock R, Clark D. Adverse effects of fluorescein
angiography in hypertensive and elderly patients. Acta Ophthalmol Scand.
2006 Nov;84(6):740–2.