Corresponding author:
Name- Sushil Kumar Sah
Email ID- sushilsahoptom24@gmail.com
Address- Biratnagar Eye Hospital Rani Millis area Morong (Nepal)
HHh
Phone number- +917979836838
Introduction
Fundus fluorescein angiography (FFA) is a commonly utilized imaging
technology in ophthalmology to provide more details of the health of the
back of the eye [1]. Its shows dynamic effects caused by delayed
vascular filling in various regions and blood vessel leaks due to
inflammation or increased intracranial pressure in addition to allowing
the detection of vascular anomalies [2]. Sodium fluorescein
(C20H10O5Na2), an organic dye with a molecular weight of 376 Daltons is
used for the procedure [3]. Most cases where this procedure is
recommended are those with retinal disorders including diabetic
retinopathy, hypertensive retinopathy, and central serous retinopathy.
Although the fact that multiple negative effects have been shown in
research, these are categorized as mild (nausea and vomiting), moderate
(skin allergy), and severe (bronchospasm, laryngeal edema, other skin
eruptions, urticaria, other skin rashes, syncope, thrombophlebitis,
pyrexia, local tissue necrosis, and unintentional arterial injection)
[4]. Previous studies indicated that moderate adverse effects are
the most common (0.73–14%), with nausea and vomiting being the most
frequent. Moderate and severe reactions are infrequent (1%) [5].
The proposed mechanisms are often classified into one of the following
groups: 1) Anaphylactoid reaction: production of histamine in the
absence of immune response 2) Immediate immune (IgE-mediated)
anaphylactic responses hypersensitive reaction, and 3) bradycardia and
arterial hypotension as a result of vagal reactions. 3) bodily or mental
stress, 4) a vasospastic reaction to a direct harmful pharmaceutical
impact the impact of drug contamination, 5) tachycardia and cardiac
stress brought on by anxiety-related medullary sympathetic discharge, 6)
and systemic effects as well [6]. In this study, we compare the most
common complication of fluorescein fundus angiography in patients who
were fasting to those who hadn’t before the procedure.
Materials and Methods
The Ethics Committee of Biratnagar Eye Hospital Institutional Review
Committee approved this Cross-sectional comparative study. This study
adhered to the declaration of Helsinki.
A Cross-sectional comparative study was undertaken of patients who had
undergone FFA at Biratnagar Eye Hospital. First, the patient attended
the department on the date of his or her investigation as an outpatient
and was managed according to a set protocol. Informed consent was
obtained when the test was first ordered by an Ophthalmologist. A nurse
and an optometrist used an established questionnaire to collect a
medical history when the patient arrived. Age, gender, previous medical
history, allergies, and the number of FFA investigations were among the
details provided. Additionally, the patient’s blood pressure and pulse
were checked 20 minutes before and after the procedure. Following that,
topical tropicamide 1% and phenylephrine 2.5% were used to dilate the
patient’s pupils. After peripheral upper limb vein cannulation for
intravenous access, 3 ml of 20% fluorescein was administered as a quick
(4-6 second) bolus. After the procedure was completed, the patient
stayed in the area for an additional hour, and any adverse effects were
noted along with when they first occurred. All asymptomatic patients who
had breakfast prior to the FFA procedure were compared to those who had
not.
statistical analysis
SPPS version 25.0 was used for data analysis.
The P-Value was determined using the chi-square test and Fisher’s exact
text association was used. It was considered statistically significant
if P values were <0.05.
Results:
Obtained data on 210 patients, (Age range 20 - ≤71 years). There were
29.52 % females and 70.48 % males in the population.
The total adverse reaction rate (AR) included nausea and vomiting
(11.32%) without diet and with diet (7.69%), skin allergy (1.89%)
without diet and with diet (1.92%), and unconsciousness (0.94%)
without diet and with diet (2.88%). There were no fatalities or
significant cardiovascular issues. Three people needed medical attention
for respiratory issues (Table 1, Figure 1).