Eye Angiography: Advanced Diagnosis in Retinal Health

Eye Angiography: Advanced Diagnosis in Retinal Health

Eye angiography is one of the most effective methods for diagnosing retinal diseases and problems in the structures at the back of the eye. Fundus Fluorescein Angiography (FFA), known in everyday language as eye angiography, maps the blood circulation in the posterior segment of the eye in real time and at high resolution. Eye angiography is not only a screening tool, but also a strategic guide that determines treatment planning.

At the Eye Diseases Department of Daviva Health Group, vascular changes that cannot be detected with routine examinations are analyzed at a microscopic level using the eye angiography method.

You can find answers to all the questions you may have, such as “Is eye angiography a painful procedure?” and “Can I drive after eye angiography?” in this article.

What Is Eye Angiography?

Eye Angiography, known in medical literature as Fundus Fluorescein Angiography (FFA), is an advanced imaging method used to examine the retina’s blood circulation, vascular structure, and the tissue layers beneath the retinal layer.

Eye angiography is performed to detect vascular problems that cannot be seen with light and lenses during routine eye examinations. It is carried out with the help of a special fluorescent dye administered through the bloodstream.

In What Situations Is Eye Angiography (FFA) Used?

Eye angiography goes beyond routine examinations and allows the retinal vascular map to be analyzed at a microscopic level.

• It is one of the most critical tools for protecting eye health in patients with diabetes.
• It clarifies the treatment plan by determining the type of leakage, such as in macular edema.
• It detects abnormal vessel growth that could lead to vision loss at an early stage.
• In retinal vein occlusions, it distinguishes ischemic from non-ischemic cases.
• In retinal artery occlusions, it documents the speed of blood flow and the degree of blockage.
• Especially in wet age-related macular degeneration, it identifies leaking vascular networks that develop beneath the retina.
• In cases of uveitis and vasculitis, it visualizes active inflammation and leakage in the vessels.
• It makes a differential diagnosis by analyzing the characteristic vascular structures of melanoma, hemangioma, or metastases that have spread to the eye from another organ.
• It creates a treatment map before laser photocoagulation or intraocular injections.
• It is used to confirm the success of the treatment applied.

How Is Eye Angiography (FFA) Performed?

Eye angiography is not a surgical intervention. It is a dynamic imaging process that takes about 15–20 minutes and maps the retina’s vascular structure.

• Before the procedure, the patient is given detailed information about the process and consent is obtained.
• A history of allergies, kidney disease, or pregnancy is carefully reviewed.
• Special mydriatic drops are instilled to allow the back structures of the eye to be seen clearly. About 20–30 minutes are waited for full dilation.
• The patient is comfortably positioned in front of the camera with the chin and forehead supported to ensure image stability.
• To obtain a clearer image, a special dye is injected. For this, an intravenous line is placed in the arm. The special dye is injected through the vein.
• Blue light that will excite the dye and yellow-green barrier filter systems that will capture the dye’s fluorescence are activated in the camera system.
• The first moment the dye reaches the choroidal vascular layer at the back of the eye is observed.
• As the dye fills the retinal arteries, the vascular structure begins to appear clearly.
• In the phase where blood passes through the capillaries and reaches the veins, the flow showing filling from the vessel edges toward the center is observed.
• Leakage analysis is completed by examining whether the dye is completely cleared from the vessels or remains in the tissues.
• The patient is monitored by our expert team for about 30 minutes for rare allergic reactions.
• If no issues are observed, the intravenous line is removed and the eye angiography is completed.

What Awaits You After Eye Angiography?

• Due to the drops used during the eye angiography procedure, your vision may remain blurry for 4–12 hours.
• Because of the extreme sensitivity to light, it is definitely recommended to wear sunglasses after the procedure.
• A temporary yellowish-orange tint on your skin and a bright fluorescent yellow color in your urine for 1–2 days due to the injected dye during the procedure are completely normal and harmless.
• A metallic taste in the mouth or mild nausea may continue immediately after the procedure. This usually goes away on its own shortly.
• Mild tenderness or bruising in the intravenous line area on your arm for a few days is normal.

Advantages of Eye Angiography (FFA)

• Eye angiography visualizes not only the retinal surface but also blood flow, leakage, and vascular blockages beneath the tissue dynamically. This allows even the smallest pathologies that may be missed in routine examinations to be detected.
• In age-related macular degeneration (macular degeneration), it reveals whether the disease is exudative.
• Before laser photocoagulation or intraocular injection treatments, it determines the exact location and amount of leakage and creates a precise treatment map.
• By determining the type of diabetic macular edema (focal or diffuse), it allows the selection of the most appropriate treatment approach to minimize the risk of vision loss.
• It shows blood flow speed and vascular permeability in real time. It also provides the most objective data to confirm the success of laser or injection treatments.
• In intraocular tumors, it analyzes the vascular structure to determine the tumor’s character. It plays a critical role in the differential diagnosis of metastases spread from other organs.

What Are the Risks of Eye Angiography?

Eye angiography (FFA) is a diagnostic method safely performed on millions of patients worldwide with a very low complication rate. However, since it is an invasive procedure involving dye injection through a vein, it is important to be aware of some side effects.

• Some patients may experience nausea and vomiting. This resolves within a few minutes.
• A bright yellow or orange discoloration related to the dye may be seen on the skin for 6–12 hours and in the urine for 1–2 days.
• A short-term chemical or metallic taste may be felt in the mouth.
• Allergic reactions such as itching, hives, or rash may occur on the skin.
• If the dye leaks out of the vessel into the surrounding tissue, localized swelling and pain may occur in the area.
• Very rarely, allergic reactions accompanied by difficulty breathing or low blood pressure may occur.
• Because the effects are not fully known, it should not be performed unless necessary during the first 3 months of pregnancy.
• Breastfeeding mothers are advised not to breastfeed for 3–4 days after the procedure.
• In patients with diabetes, blood and urine glucose values may appear falsely elevated for a few days after the procedure.
• Due to pupil dilation and the camera’s bright flash, sensitivity in vision may occur for 1–2 days.

FREQUENTLY ASKED QUESTIONS ABOUT EYE ANGIOGRAPHY

Is eye angiography a painful procedure?

No, eye angiography is not a surgical intervention and does not require anesthesia. Only an intravenous line is placed so that the dye can be injected through a vein in your arm. The only discomfort felt at this stage is similar to the needle prick during a routine blood test. Although the bright flashes used during imaging may cause a temporary glare sensation in your eyes, they do not cause pain.

Do I need to fast before the procedure?

Complete fasting is not required for eye angiography (FFA); however, because the fluorescent dye injected during the procedure may cause short-term nausea in some patients, it is recommended not to eat heavy meals within 2–3 hours before the procedure and to prefer a light feeling of fullness.

How long does eye angiography take?

The process consists of two stages. Dilating your pupils with drops takes about 20–30 minutes. The actual angiography imaging and the dynamic phase in which the dye passes through the vessels are usually completed within 10–15 minutes.

Can I drive after the procedure?

No, you should absolutely not drive. The drops used to dilate the pupils and the camera flashes cause significant blurring of vision and intense light sensitivity that can last 4–12 hours. For your safety, it is recommended that you come to the procedure with an accompanying person or use public transportation or a taxi on the way back.

Does the dye harm the kidneys or the body?

The fluorescein dye used in FFA is different from the iodine-based dyes used in radiological angiography and is generally quite safe. The dye is eliminated from the body through the kidneys. Drinking plenty of water after the procedure is enough to speed up this process and support your kidneys. It is important for only patients with severe kidney failure to share this with their doctor before the procedure.

When can I return to my daily life after the procedure?

Most patients can fully return to their normal activities the next day. However, on the day of the procedure, reading, using a computer, or tasks requiring fine detail should be avoided until vision clears. It is also important to use sunglasses against light sensitivity.