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PubMed1987

Retinal microaneurysm counts in diabetic retinopathy: colour photography versus fluorescein angiography.

Microaneurysms were counted separately in a masked manner on stereo colour fundus photographs and on stereo fluorescein angiograms of 100 patients with unselected forms of diabetic retinopathy. Serial studies obtained 6 months apart were available for most patients, and a total of 315 separate photographic studies were evaluated. In addition, 118 photographic studies of 38 young patients with type I diabetes mellitus were evaluated. About twice as many microaneurysms were detected on the fluorescein angiograms as on the colour photographs for both groups of patients (p less than 0.05). Fluorescein angiography showed microaneurysms in 57% of the eyes in the second group photographed for the first time that had no detectable microaneurysms on colour photography. The use of fluorescein angiography is recommended in diabetic patients when detection of subtle microvascular abnormalities is deemed essential.

Aneurysm↗
PubMed1985

Chloroquine retinopathy. Is fluorescein angiography necessary?

Color fundus photographs and corresponding fluorescein angiograms from 83 patients suspected of having chloroquine retinopathy were reviewed in a retrospective masked study to determine the relative sensitivity of these two photographic methods in the diagnosis of retinal toxicity. We identified retinal toxicity on both color photographs and fluorescein angiograms in 7.6% of cases, on the color photographs but not on the corresponding angiograms in 6.1% of cases, and on the fluorescein angiograms but not on the color photographs in 1.5% of cases. Fluorescein angiography may not be as sensitive as color fundus photography (or ophthalmoscopy) in the diagnosis of chloroquine retinopathy.

Chloroquine↗
PubMed1979

The fluorescein appearance test for lacrimal obstruction.

The fluorescein appearance test has been developed for the evaluation of the patency of the lacrimal excretory system. This objective test is simple, painless, physiologic, and reliable. The only materials required are 2% fluorescein, ultraviolet light, and a tongue blade. A 2% fluorescein solution is instilled in the conjunctival cul-de-sac after which the posterior oropharynx and nostrilis are examined with ultraviolet light. Over 90% of 92 eyes from 66 normal subjects gave positive results within 30 minutes and 100% gave positive results within 60 minutes. Slow appearance times can be anticipated because there appears to be a correlation between Schirmer test values and the time required for a positive fluorescein appearance test. The test proved clinically useful in evaluating patients with epiphora and in making the diagnosis of several cases of lacrimal obstruction verified by nuclear dacryocystography.

Adolescent↗
PubMed1979

Corneal staining subsequent to sequential fluorescein instillations.

Liquid fluorescein (2%) was instilled into the inferior cul-de-sac and the precorneal tear film and the cornea were observed utilizing a specialized examination routine. Following the initial fluorescein instillation and observations, sequential fluorescein instillations were performed at five-minute intervals six additional times. The incidence of corneal staining (200 corneas) following the initial instillation of fluorescein was 19%. An additional 23% exhibited staining as a result of the sequential staining process. Five types of staining were classified; the most common forms were those associated with the lid margins. Severe degrees of staining appear to be clinically significant, as suggested by a correlation between severe degrees of staining and contact lens intolerance.

Contact Lenses↗
PubMed1982

A comparison of healing of corneal epithelial wounds stained with fluorescein or Richardson's stain.

The effects of fluorescein and Richardson's stain on corneal epithelial wound healing were compared in eyes of rabbits whose corneas had the epithelium removed by scraping or by n-heptanol. One eye of each rabbit was stained with fluorescein and the other eye was stained with Richardson's stain at intervals throughout the healing process, and the wounds were photographed for planimetry and determination of re-epithelialization rate. Corneal thickness was also measured throughout the re-epithelialization. These studies showed that Richardson's stain, as compared with fluorescein, decreases re-epithelialization rate, delays wound closure, and slows the return of the edematous cornea to normal thickness. Therefore fluorescein rather than Richardson's stain should be used to stain epithelial defects in corneal wound healing studies and in the evaluation of the corneal toxicity of chemical agents.

Animals↗
PubMed1983

Prediction of skin viability following en bloc resection for osteogenic sarcoma with fluorescein.

Intravenous fluorescein dye was applied as a test of skin viability in 11 en bloc resections for osteogenic sarcoma about the knee. Intravenous fluorescein dye is an easy, safe, efficient, and inexpensive method that helps to predict the viability of surgically created skin flaps. When patchy fluorescence is observed, primary debridement is recommended to prevent immediately postoperative skin necrosis. This test proved to be an accurate, significant indicator of nonviable skin, in both location and dimension. All flaps that were patchy by the fluorescein test consisted of nonviable skin. Conversely, flaps that took up the dye evenly went on to uneventful wound healing. The fluorescein test should be considered for further application in orthopedic surgical procedures when skin viability is uncertain, e.g., in cases of trauma and complicated reconstructions about the knee and elbow.

Bone Neoplasms↗
PubMed1984

[Studies on the prediction of intestinal recovery from ischemic injury by fluorescein fluorescence patterns].

Methods for the prediction of intestinal recovery from ischemic injury were evaluated in highly reproducible model of segmental intestinal strangulation in the rat. Systemic variables were minimized and survival was maximized by parenteral administration of antibiotics and nutrient solution, so that necrosis or recovery of the segment itself, not the rat, could be used as an endpoint of experiments. Recovery of ischemic intestine was assessed by two methods: Standard clinical criteria (color, peristalsis, pulsation.) Fluorescence after intravenous fluorescein injection. Findings were compared with ultimate viability assayed by histologic examination of each segment removed 48 hours after release of strangulation. Five distinctive patterns of fluorescein fluorescence were identified, two of which (normal pattern and fine granular pattern) reliably predicted survival of the segment, and two of which (perivascular pattern and no fluorescence) predicted subsequent necrosis. A fifth, coarse granular pattern usually, but not always, predicted non-recovery. Standard clinical criteria were relatively insensitive and could not be relied upon to detect nonviable segments. The fluorescein fluorescence method correctly identified all nonviable segments at the expense of an acceptably low overall false positive rate. This study suggests that the fluorescein methods is the method of choice for the prediction of small intestinal recovery following ischemic injury.

Animals↗
PubMed1980

Fluorescein angiography in persons with slightly abnormal glucose tolerances.

Retinal fluorescein angiography was performed in 54 borderline diabetics and 23 normoglycemic controls. In 24 subjects of the borderline diabetics and 18 of the controls hemoglobin AIc, serum cholesterol, serum triglyceride, serum lipoproteins and urinary excretion of 9 plasma proteins were measured. In 50% of the borderline diabetics fluorescein angiographic dots were disclosed contrary to 25% in the controls. These findings did correlate with a hereditary pre-disposition to diabetes, but not with age and smoking habits. In the borderline diabetic group 41% had increased levels of hemoglobin AIc (greater than or equal to 6.5%) and serum cholesterol (greater than or equal to 8 mmol/l). No correlation between fluoresceinangiographic abnormalities and increased concentrations of hemoglobin AIc and serum cholesterol was present. These results are discussed with reference to previous reports of retinopathy in subjects with and without impaired glucose tolerance test and newly diagnosed overt diabetes. Subtle retinal microvascular abnormalities demonstrated by fluorescein angiography may be present in persons with moderate impaired glucose tolerance. However, the variations of the retinal fluorescein angiogram of normal individuals are at the present inadequately studied.

Adult↗
PubMed1982

Fluorescein transport in the anterior uvea.

Rabbit ciliary body-iris preparations accumulate 14C-fluorescein against a concentration gradient when incubated in Tyrode's solution at 37 degrees C and pH 7.4 for 1 hr. Under these conditions, fluorescein metabolism is negligible. This accumulation is depressed by cyanide, dinitrophenol, iodoacetate, by incubation in glucose-free medium, and by incubation at 0 degrees C. This uptake is not inhibited significantly by incubation in sodium-free medium, and relatively high concentrations of ouabain are necessary to cause inhibition. Initial uptake studies show saturation kinetics with half-saturation concentration = 0.12 mM and maximum accumulation rate = 2.3 mmoles/hr/kg wet tissue weight. Fluorescein thus appears to accumulate by a carrier-mediated active uptake process. On the basis of series of competition experiments, it is concluded that fluorescein uptake and p-aminohippurate uptake occur by similar, although not identical, mechanisms.

Animals↗
PubMed1980

Fluorescein angiography printouts.

Nineteen years after the pioneering efforts of Novotny and Alvis, fluorescein angiography has reached a level of acceptance and use which reflects its high value in ophthalmic diagnosis. Angiography laboratories are commonplace in hospitals, and many private physicians own fundus cameras and perform fluorescein angiograms routinely. As the use of this test has substantially increased, so has the number of methods used to present the film for analysis and interpretation. At this writing there are no fewer than 12 different ways of presenting fluorescein angiograms in common use (Table 1). Not all of these techniques are able to yield equal amounts of information, however, and as consultations between different laboratories occur, much difficulty results from the disparate styles. Evaluation of these varying techniques of fluorescein angiography presentation depends on the production complexity and the amount of useful information which each may yield.

Fluorescein Angiography↗
PubMed1994

[Intraoperative fluorescein angiography with an ultrasensitive imaging tube].

Fluorescein angiographic examination may be prevented by vitreous hemorrhage or opacities in vitreoretinal diseases before vitrectomy. We performed intraoperative fluorescein angiography for such cases, using a conventional light source and an ultrasensitive video camera equipped with a silicone intensifier target tube to avoid retinal phototoxicity. Intraoperative fluorescein angiograms allowed evaluation of neovascular vessels, proliferative tissues, and avascular areas associated with diabetic retinopathy. Indentation of the pars plicata enabled us to also record fluorescein images of the area. This device may aid intraoperative assessment of vitreoretinal diseases including diabetic retinopathy.

Fluorescein Angiography↗
PubMed1993

Fluorescein angiographic appearance of Dalen-Fuchs nodules in sympathetic ophthalmia.

A case of sympathetic ophthalmia is presented in which a single lesion located posteriorly at the level of the retinal pigment epithelium caused a serous macular detachment. We believe that this lesion represented an atypical Dalen-Fuchs nodule. Most reports of the fluorescein angiographic appearance of Dalen-Fuchs nodules describe multiple sites of choroidal leakage during the early phases, which may coalesce during the late phases of the angiogram. The lesion we detected was hypofluorescent in early phases of the fluorescein angiogram and showed late staining. The early hypofluorescence seen in the lesion may be explained by an intact retinal pigment epithelium over the presumed Dalen-Fuchs nodule, blockage of choroidal fluorescence by the nodule, and areas of granulomatous inflammation in the inner choroid and choriocapillaris. The staining in the late phases of the fluorescein angiogram may be explained by accumulation of fluorescein into the presumed Dalen-Fuchs nodule.

Adult↗
PubMed1977

Fluorescein-labeled estradiol: a probe for anti-estradiol antibody.

A fluorescent estradiol derivative binds strongly to antiestradiol antibody. The binding, measured by fluorescence polarization, is inhibited by estradiol and by diethylstilbestrol. Tentatively characterized as N-(estradiol-6-iminooxyacetyl) fluorescein amine, the derivative was prepared from estradiol-6-iminooxyacetic acid, dicyclohexylcarbodiimide, and fluorescein amine, and isolated by TLC. It has a fluorescence emission similar to that of fluorescein and an absorption spectrum consistent with a fluorescein: estradiol molar ratio of 1:1.

Antibodies↗
PubMed1990

Retinal circulation times in quantitative fluorescein angiography.

We tried to obtain an overview of the quantitative state of the retinal circulation. Optical density measurements by an image analyzer were performed on video fluorescein angiograms for the determination of dyedilution curves. To ensure that curves with a sharp peak were obtained, 1 ml sodium fluorescein 10% was flushed with 20 ml physiological saline. From dilution curves of a retinal circulation times, T(x) (x = 1, 25, 50, 75, and 100) and Tm, were calculated. T(1) corresponds to the difference in the time of initial dye appearance; T(50), to the so-called half-maxim time difference; T(100), to the difference in the time to peak intensity; and Tm, to the mean circulation time. T(50) showed the best reproducibility when it was examined at 49 retinal regions of 10 healthy volunteers with a double video-fluorescein angiogram that was obtained within 1 min. Normal values (mean +/- SD) at the temporal superior region of 37 healthy volunteers were as follows: T(1) = 0.87 +/- 0.66 s, T(25) = 1.52 +/- 0.48 s, T(50) = 1.83 +/- 0.50 s, T(75) = 2.12 +/- 0.56 s, T(100) = 2.73 +/- 0.76 s, and Tm = 2.69 +/- 1.25 s. We believe that these values give a general overview of the quantitative state of normal retinal circulation.

Adolescent↗
PubMed1986

Fluorescein angiography basic science and engineering.

Fluorescein angiography is an application of the physical phenomenon of fluorescence, which is phosphorescence in which the quantum mechanical decay curve is so rapid that it appears instantaneous, and it consequently has no afterglow. Sodium fluorescein is excited by light energy between 465 and 490 nm, and it decays into a lower state emitting light energy between 520 and 530 nm as fluorescent radiation. The free electrons available for excitation are reduced by chemical bonding between the fluorescein dye and plasma proteins to which up to 80% of the dye is bound in the bloodstream, thus reducing overall fluorescence. Optimalization of the observed and recorded fluorescence is afforded by providing exciter and barrier filters with as little overlap as possible to reduce or eliminate contrast reducing pseudofluorescence.

Chemical Phenomena↗
PubMed1993

Topical flurbiprofen in extracapsular cataract surgery: effect on pupillary diameter and iris fluorescein leakage.

Recent clinical studies indicate that flurbiprofen, a cyclooxygenase inhibitor, prevents miosis and breakdown of the blood-aqueous barrier during cataract surgery. Yet based on clinical and experimental data, some researchers do not agree that flurbiprofen prevents miosis. We conducted a double-blind clinical study of the effects of topical 0.03% flurbiprofen sodium on intraoperative pupillary diameter and iris fluorescein leakage after extracapsular cataract surgery. In the first phase of the study, 120 patients who had extracapsular cataract extraction with posterior chamber intraocular lens implantation were randomly assigned to receive preoperative topical flurbiprofen or a placebo, with or without intraoperative epinephrine, in addition to the standard regimen. In the second phase, 60 of the 120 patients continued the topical flurbiprofen or placebo for one month postoperatively. Iris fluorescein angiography was performed at the end of the first and the fourth weeks. The results indicate that flurbiprofen was significantly more effective (P < .0001) in maintaining mydriasis during surgery than the placebo. This action was enhanced by intraoperative epinephrine. Flurbiprofen also significantly reduced (P < .001) postoperative iris fluorescein leakage.

Administration, Topical↗
PubMed1997

Early versus late staining of microaneurysms in fluorescein angiography.

PURPOSE: To analyze the appearance and disappearance of microaneurysms in different phases of fluorescein angiography. METHODS: Three fluorescein angiograms were taken at 13-month intervals during a 26-month follow-up period from 13 patients with type I diabetes and mild background retinopathy. Two frames of the angiogram were analyzed: one from the transit phase and the other from the late phase of the angiogram. Individual microaneurysms were identified and localized from each frame using a computerized system for retrieval of the coordinates for each microaneurysm. Microaneurysms identified by their location then were analyzed in relation to the phase of the angiogram in which they were visualized and their disappearance during follow-up study. RESULTS: Thirty-three percent of the microaneurysms were visualized only in the early phase, 31% in only the late phase, and 36% in both phases of the fluorescein angiogram. The microaneurysms frequently changed their phase of appearance in the angiogram during follow-up study. CONCLUSION: During the 26-month follow-up period, between 55% and 80% of the microaneurysms present at baseline disappeared. The phase of the baseline angiogram in which the microaneurysms were visualized did not determine their disappearance rate.

Adult↗
PubMed1965

PREPARATION OF FLUORESCEIN ISOTHIOCYANATE-LABELED GAMMA-GLOBULIN BY DIALYSIS, GEL FILTRATION, AND IONEXCHANGE CHROMATOGRAPHY IN COMBINATION.

Dedmon, Robert E. (Presbyterian-St. Luke's Hospital, Chicago, Ill.), Albert W. Holmes, and Friedrich Deinhardt. Preparation of fluorescein isothiocyanate-labeled gamma-globulin by dialysis, gel filtration, and ion-exchange chromatography in combination. J. Bacteriol. 89:734-739. 1965.-Antiviral immune gamma-globulins isolated from rabbit and guinea pig sera were labeled through dialysis membranes with fluorescein isothiocyanate and purified in several ways to eliminate nonspecific staining. Gel filtration of the conjugate with Sephadex G-25 coarse beads followed by column fractionation with diethylaminoethyl-Sephadex yielded consistently highly specific staining materials. Fluorescein-protein ratios varied between 1.0 and 4.0. This technique has proved to be simple and reliable, and is less time-consuming than previous techniques.

Animals↗