INFORMED CONSENT FOR A RETINAL ANGIOGRAPHY

Your ophthalmologist proposes to perform a retinal angiography with fluoresceine in order to get a thorough examination of your retinal conditions.

This document contains the information about the reasons, conditions, results, risks and limitations of the proposed medical act.

WHY THIS EXAMINATION?

Retinal angiography with fluoresceine is a valuable tool to evaluate the status of your retinal vessels.
 

This examination is used to establish the diagnosis of certain eye diseases and to guide their treatment, especially when laser photocoagulation is considered.

The most common indications for retinal angiography with fluoresceine are: diabetic retinopathy, retinal degeneration, myopic retinopathy, retinal vein occlusion, retinal arterial occlusion, pseudofakic macular oedema etc.

HOW IS IT REALISED?

It is done on an outpatient (not hospitalized) mode but needs to dilate your pupils.
 

Photographs of your eye fundus are taken after an injection of fluoresceine, a dye, in a vein, usually from the elbow or the back of the hand, that is to say the locations normally used in a blood test. After the injection, snapshots of your eye fundus are taken during 5 to 20 minutes.

The total duration of this examination is about one hour: about twenty minutes to dilate the pupils, twenty minutes for the injection and taking the photographs and twenty minutes of prudence waiting time before you leave.

During the examination, you are requested to keep calm and strictly follow the instructions given by your ophthalmologist.

USUAL COURSE

In the vast majority of the cases, the examination is well tolerated and you can leave and return within hours to your normal activities.
 

A control will be necessary at a date which will be recommended by your ophthalmologist.

COMPLICATIONS OF THIS EXIMANATION

As in any invasive procedure, there are side effects, the majority of which is not serious:
 

* Glare, due to the laser session itself and to the pupil dilation, will be felt throughout the examination and will last 2 hours. It is advisable to have sunglasses when leaving the Cabinet and not to drive as long as you feel this glare.

* Pale yellow coloration of the skin and urine, lasting several, sometimes 24, hours.

* Pain at the moment of the injection. The intravenous injection of the product is painless. Mild to moderate pain can occur if the dye flows outside the vein. This incident is of no consequence.

* Transient nausea within the minutes after the injection. It occurs in 8% of the cases. Fasting increases the risk of its occurrence. Vomiting is rare.

* Arterial hypotension may occur in susceptible individuals. It will quickly disappear when lying down.

* Extended pupil dilation for several days. It is annoying by the glare it induces. This risk is unpredictable and very rare.

These incidents are of no concern. If you have ever experienced any of them at a previous angiography, report it below in this document. In such a case, your ophthalmologist will give you medications before the start of the examination in order to improve your comfort and to avoid stop taking photographs.

Serious complications are:

* Severe allergic reaction. It is unpredictable and rare, occurring in less than 1% of cases.

* Crisis of acute glaucoma. This risk is inherent to all dilation of the pupils. It is exceptional and not quantifiable.

* Cardio-vascular shock. It is a serious, sometimes fatal, incident. It can occur unpredictably in spite of all precautions. This complication is extremely rare (less than 220 000 cases of examinations)

These complications can occur during the examination or shortly thereafter. This is why you are asked to wait about 20 minutes after the examination and before leaving the office of your ophthalmologist.

THE LIMITS OF THE ACT

Some retinal lesions may be too small or too deep in the retina to be detected by this examination.
 

PRECAUTIONS TO BE TAKEN

Do not forget to remove, one hour after the completion of the examination, the tape placed on the site of injection
 

During pregnancy, no complications due to fluoresceine have been reported to the mother neither to the child to be born.

As fluoresceine is excreted in breast milk, it is recommended to discontinue breastfeeding during the two days following the examination.

In case of known allergy to fluoresceine, an oral pre-medication or injection can be proposed to prevent the reactions of intolerance and allergy.

In any doubt, please ask your eye doctor for additional information.

YOU SHOULD CONTACT YOUR OPHTHALMOLOGIST IMMEDIATELY IN CASE OF

  • Breathing difficulties
  • General malaise
  • Fever
  • Continued strong pain at the site of injection lasting more than 24 hours.
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