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Fluorescein angiography is the traditional tool for the detection of choroidal neovascularization of age-related macular degeneration. However, some limitations exist which impede its efficacy in the detection of subretinal neovascularization. Indocyanine green videoangiography is a recently developed technique which differs from fluorescein angiography in many ways. We performed indocyanine green videoangiography in 18 eyes with occult choroidal neovascularization, demonstrated by fluorescein angiography. Sixteen of the 18 eyes showed an abnormal vessel loop in the early phase of indocyanine green videoangiography. In the late phase, all 18 eyes had abnormal dye retention around the suspected neovascular area; however, only 12 eyes revealed a distinct border of neovascularization. No side effects, such as nausea, vomiting, or allergic reactions, were noted in our patients. Advantages and drawbacks of indocyanine green videoangiography in comparison with fluorescein angiography are discussed.
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PMID:Indocyanine green videoangiography of choroidal neovascular membrane in age-related macular degeneration. 750 72

We examined whether a prick test was a valuable method in comparison with an intradermal skin test for predicting an anaphylactoid reaction to intravenous injection of fluorescein solution. Fifteen hundred cases were tested. The number (rate) of positive reactions to the prick test with 10% and 1.0% fluorescein solution was 2 (0.1%) and 0 (0.0%), respectively. In contrast, positive reaction to the intradermal skin tests with 10% and 0.1% fluorescein solution was observed in 686 cases (45.7%) and 13 cases (0.9%), respectively. Fluorescein angiography (FAG) was performed in 1,499 of the 1,500 cases. Adverse reactions such as nausea, cough, cold sweat, urticaria, and shock were noted in 85 cases (5.7%). Typical anaphylactoid shock occurred in one case (0.07%), which was one of the two cases positive to the prick test with 10% fluorescein. In the other positive prick test case, FAG was cancelled because of the high probability of anaphylactoid shock. The results suggest that a prick test with 10% fluorescein solution can markedly cut down the false positive reactions and can be a useful test for the prospective diagnosis of anaphylactoid reactions to intravenous fluorescein administration.
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PMID:[Usefulness of the prick test for anaphylactoid reaction in intravenous fluorescein administration]. 864 45

We report a case of blindness due to occlusion of the ophthalmic artery following injection of autologous fat into the glabellar region for cosmetic surgery. A 30-year-old woman underwent aspiration of autologous fat from her gluteal region and injection of it into her breasts, nose, and glabellar area. At the time of injection into the glabellar area, she suffered nausea, pain, and visual loss in her right eye. She consulted an ophthalmologist. The first examination revealed that her right eye had loss of light perception, widespread retinal whitening, and obstruction of the retinal vessels of the fundus. It was suspected that she had occlusion of the central retinal artery, and drip infusion of urokinase and hyperbaric oxygen therapy were implemented. Since no improvement was seen, she was referred to Shinshu University hospital. Fundoscopy showed remarkable edema of the entire right retina and whitened retinal vessels. Fluorescein angiography showed no filling of the right retinal arterioles. Cerebral angiography showed complete obstruction of the right ophthalmic artery at its bifurcation. Subsequent administration of urokinase and corticosteroid had no effect. We considered that occlusion of the ophthalmic artery happened when autologous fat was injected into the glabellar area.
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PMID:[A case of ophthalmic artery obstruction following autologous fat injection in the glabellar area]. 1730 92

Fluorescein angiography (FA) and indocyanine green angiography (ICGA) have been the gold standard for the evaluation of retinal and choroidal vasculature in the last three decades and have revolutionized the diagnosis of retinal and choroidal vascular diseases. The advantage of these imaging modalities lies in their ability to document retinal and choroidal vasculature through the dynamic assessment of contrast transit over time in the intravascular and extravascular spaces. However, disadvantages include the absence of depth resolution, blurring of details by contrast leakage, and the inability to selectively evaluate different levels of the retinal and choroidal microvasculature. In addition, these angiographic methods require intravenous dye, which may cause adverse reactions such as nausea, vomiting, and rarely, anaphylaxis. Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that, in contrast to dye-based angiography, is faster and depth-resolved, allowing in some cases for more precise evaluation of the vascular plexuses of the retina and choroid. The method has been demonstrated in the assessment of various vascular diseases such as venous occlusions, diabetic retinopathy, macular neovascularization, and others. Limitations of this imaging modality include a small registered field of view and the inability to visualize leakage and dye transit over time. It is also subject to a variety of artifacts, including those generated by blinking and eye movement during image acquisition. However, more than an alternative for FA and ICGA, OCTA is bringing new insights to our understanding of retinal and choroidal vascular structure and is changing fundamental paradigms in the clinical management of pathologic conditions. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:848-861.].
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PMID:Optical Coherence Tomography Angiography of Chorioretinal Diseases. 2763 82