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Fluorescein iris angiography in nodular sarcoid iritis.

The value of fluorescein iris angiography in the diagnosis and follow-up of nodular sarcoid iritis was studied in five patients with nodular iritis and histologically verified generalized sarcoidosis. On the angiograms the sarcoid nodules appeared as hyperfluorescent patches which always exceeded the number of nodules seen by biomicroscopy. Fresh iris nodules were characterized by mild diffuse fluorescence and dilatation and leakage of the adjacent vessels whereas old granulomas were covered by tortuous neovascular vessels which in the active stage of the disease leaked fluorescein profusely. After recovery or between recurrent attacks the amount of leakage decreased or stopped although the neovascular network did not disappear. At recurrences new areas of fluorescence due to fresh nodules were observed in addition to intense leakage from some of the previous lesions. Most of the small nodules were situated in the pupillary part of the iris resulting in dilatation and abnormal permeability of all the peripupillary vessels. The weakness of absence or diffuse leakage from the radial vessels of the iris agrees with the proliferative nature of sarcoid nodular iritis and explains the low-grade symptoms of the patients.

Adult↗

Leber's optic neuropathy II. Fluorescein angiographic studies.

Fluorescein angiography was performed in 71 persons at risk to develop Leber's Optic Neuropathy (L.O.N.), in 10 females carriers of this disease and in 5 patients during the acute phase. The examination was performed in three university eye clinics. The angiograms were randomly mixed with an equal number of 'controls' and reviewed in a blind fashion on two occasions by two observers. A scoring system was developed on the basis of the peripapillary microvascular changes known to occur in the acute phase of L.O.N. All 5 patients could be recognised in this manner. In the pictures of one of the clinics, which were of good quality, a significant difference in scoring between the at risk and control groups appeared to exist. The results suggest that carriers also may have the same fluorescein angiographic abnormalities. One man from the at risk group who obtained high abnormal scores-identical to patients in the acute phase-developed L.O.N. 6 months later.

Acute Disease↗

Flow cytometric analysis of antineoplastic effects of interferon-alpha, beta and gamma labelled with fluorescein isothiocyanate on cultured brain tumors.

Antineoplastic effects of interferons (IFNs) on brain tumors have often been reported in the literature, however, so far as we know, there are no reports of the study on the antineoplastic effect of IFNs (alpha, beta, and gamma) labelled with fluorescein isothiocyanate (FITC) using flow cytometry (FCM). Three established glioma cell lines and 11 cultured cells of brain tumor from surgical specimens were exposed to IFN-alpha, beta, and gamma at the concentrations of 10(2)-10(5) IU/ml for 24 h, respectively. Using FCM, the viability of the cells was evaluated with fluorescein diacetate stain and the cell cycle was analyzed from the DNA-histogram with propidium iodide stain. Furthermore, FITC-labelled IFN-alpha, beta and gamma were also contacted with each cell to calculate respective positive cells. The viability decreased about 60% on day 1 and day 3, indicating the effect of IFN-alpha and beta on U373MG cells and on some cultured glioma cells from surgical materials, whereas, IFN-gamma had no effects. Antineoplastic effect of each IFN well correlated with FITC-positive rates, demonstrating S phase block in the cell cycle. IFN-gamma had no antineoplastic effects, whereas IFN-alpha and beta showed antineoplastic effects, which fact suggested that IFN-gamma receptor be different from those of IFN-alpha and beta. The method of FITC-labelling for IFNs with the aid of FCM has the advantages as follows: 1) Antineoplasticity of IFN can be simply evaluated with FCM; 2) It is easy to analyze the action mechanism of IFN; 3) Information on the receptor is obtainable; and 4) Sensitivity can be evaluated prior to administration of IFN, suggesting possibilities of clinical application of this method.

Antineoplastic Agents↗

Automated detection and quantification of microaneurysms in fluorescein angiograms.

Fluorescein angiograms from diabetics were digitised for analysis using digital image-processing techniques. Computer algorithms were written to detect and count microaneurysms present in the images. The accuracy, speed and reproducibility of the technique were assessed and compared with those of manual counts made by clinicians from both digitised and analogue images. Free-response ROC (receiver operating characteristic) curves were used to assess the performance of both the clinicians and the computer by comparing the results with "gold standards" compiled from prints of the original fluorescein angiograms. The computer performed as well as the clinicians when the latter were analysing the digitised images (512 x 512 pixel resolution), but only when one image was acquired at 4 times this resolution did the computer's performance match that of the clinicians analysing the analogue image. The automated technique was more reproducible than the manual method.

Algorithms↗

Practical anterior segment fluorescein angiography.

Anterior segment fluorescein angiography is a useful investigative technique for diagnosing and assessing anterior segment disease. However, a number of technical problems are inherent in current methodology, such as confounding reflexes, off-axis illumination, and shallow depth of field. We developed a simple technique using readily available equipment, polarized light, and an easy-to-construct auxiliary bracket to provide an inexpensive and optimal photographic system for anterior segment fluorescein angiography.

Anterior Eye Segment↗

Anaesthesia for fluorescein angiography of the ocular fundus in the miniature pig.

A safe and reproducible procedure is described for anaesthesia and ophthalmic fluorescein angiography in the miniature pig. Twenty examinations were performed in five adult miniature pigs. A detailed description is given of the anaesthetic procedure, in particular of the techniques for endotracheal intubation and for intra-arterial and intravenous cannulation. All cardiovascular parameters recorded during the experiments remained within acceptable anaesthetic limits. The fluorescein angiographic technique, which is routinely used in human ophthalmology, was adapted for the pig. This procedure for in vivo examination of the porcine eye is interesting and useful for experimental ophthalmic research.

Anesthesia↗

The composition of Erythrosins, Fluorescein, Phloxine and Rose Bengal: a study using thin-layer chromatography and solvent extraction.

Commercial samples of Erythrosin B (CI 45430), Erythrosin Y (CI 45425), Fluorescein (CI 45350), Phloxine (CI 45410) and Rose Bengal (CI 45440) have been analysed by thin-layer chromatography. The Erythrosins were found to be mixtures consisting in the main of 4'-iodofluorescein, 4', 5'-di-iodofluorescein, 2', 4', 5'-tri-iodofluorescein and 2',4',5',7'-tetraiodofluorescein, in some instances together with 2',4',5'-tri-iodo-4,5,6,7-tetrachlorofluorescein and 2',4',5',7'-tetraiodo- 4,5,6,7-tetrachlorofluorescein. Samples of Fluorescein were mixtures of the nominal dye usually with traces of several unidentified, fluorescent components. Those of Phloxine consisted mainly of mixtures of 4'-bromo-4,5,6,7-tetrachlorofluorescein, 4',5'-dibromo-4,5,6,7'-tetrachlorofluorescein, 2',4',5'-tribromo-4,5,6,7-tetrachlorofluorescein and 2',4',5',7'-tetrabromo-4,5,6,7-tetrachlorofluorescein, often with 4,5,6,7-tetrachlorofluorescein. Samples of Rose Bengal were mixtures of 4'-iodo-4,5,6,7-tetrachlorofluorescein,4',5'-di-iodo-4,5,6,7-tetrachlorofluorescein, 2',4',5'-tri-iodo-4,5,6,7-tetrachlorofluorescein and 2',4',5',7'-tetraiodo-4,5,6,7-tetrachlorofluorescein together with some unidentified components. Most of the commercial dye samples gave an insoluble residue when extracted with methanol. This residue was usually inorganic carbonate or halide. Some possible practical consequences of the various impurities are discussed.

Chromatography, Thin Layer↗

Kinetics and disposition of fluorescein-labelled liposomes in healthy human subjects.

The in vivo kinetics and organ uptake of multilamellar liposomes have been studied in healthy volunteers. Sodium fluorescein-containing liposomes composed of equimolar amounts of egg phosphatidylocholine and cholesterol were injected into a peripheral vein in 4 healthy subjects. Blood samples collected from the femoral artery, hepatic vein and pulmonary artery, were analysed for liposomal dye content. The results, showing involvement of the reticuloendothelial system (RES) in the removal of liposomes, confirmed those previously obtained with radiolabelled preparations. Use of an innocuous liposomal marker (sodium fluorescein) and conventional vascular catheterization techniques, as employed here, may provide a reliable and clinically acceptable approach to establishing disease-induced changes in the kinetics of uptake of drug-containing liposomes by the RES, and thus help in the design of protocols for effective treatment.

Adult↗

The importance of fluorescein angiography in diagnosing pattern dystrophies of the retinal pigment epithelium.

We describe three different types of pattern dystrophies in the retinal pigment epithelium: annular dystrophy, butterfly-shaped dystrophy with features of cone dystrophy, and butterfly dystrophy. In all the cases, fluorescein angiography was a good method to evaluate the morphology and range of macular changes. The butterfly-shaped lesions were not always easily visible with the ophthalmoscope, therefore, the fluorescein angiography was diagnostic. We also examined 17 relatives of these patients to discover the mode of inheritance in these diseases. The annular dystrophy seemed to be recessively inherited or a possible sporadic case, as was the unusual pattern dystrophy with features of cone dystrophy. The dominant heredity was found in the typical cases of butterfly-pattern dystrophy.

Adolescent↗

Quantitative determination of fluorescein in the anterior chamber and vitreous body.

The blood-retinal barrier plays an important role in the physiology of the retina, the vitreous body and the aqueous humour. Many intra-ocular processes cause a breakdown of this barrier and this results in an increase in the concentration of fluorescein in the vitreous and the aqueous after it has been injected intravenously (Cunha-Vaz et al., 1975). In our clinic we have built an apparatus for the quantitative determination of the concentration of this fluorescein in both healthy and pathological eyes (Brubaker and Coakes, 1978). The goal of the present communication is to invite other workers with similar interests to compare their results with ours.

Aged↗

Lateral phase separation of phospholipids as a basis for increased permeability of membranes towards fluorescein and other chemical species.

Using mouse spleen cells, before and after treatment with glutaraldehyde or mild hyperthermia, we observe a strong correlation between permeability to fluorescein and susceptibility to staining with N epsilon-dansyl-L-lysine (irrespective of the cells' ability to exclude trypan blue). We observe the same correlation using liposomes prepared from phosphatidylcholine and varying amounts of cholesterol. We have recently introduced N epsilon-dansyl-L-lysine as a fluorescent membrane stain, or "probe," whose uptake, we propose, is selective for phospholipid domains in membranes (G.M.K. Humphries & J.P. Lovejoy Biophys. J. 42:307-310, 1983; G.M.K. Humphries & J.P. Lovejoy J. Membrane Biol. 77:115-122, 1984). The results presented here are consistent with the hypothesis that the presence or absence of phospholipid domains in membranes also modifies their permeability toward fluorescein, and suggests that permeability towards other chemical species may be similarly affected. On the basis of work using liposomes, we believe this to be the case for carboxyfluorescein and for glucose.

Animals↗

Biomicroscopy versus fluorescein angiography of the iris in the detection of diabetic iridopathy.

Iris fluorescein angiography is not commonly employed in clinical practice, but it is the most sensitive technique for the evaluation of iris vessel abnormalities. We used iris fluorescein angiography as the gold standard against which to test the ability of iris biomicroscopy to demonstrate diabetic iridopathy (DI). One hundred and fourteen eyes of 63 diabetic patients affected by preproliferative or proliferative diabetic retinopathy (DR) (the DR groups at high risk of developing DI) were considered. The DI fluorangiographic classification used was: (1) absence of DI; (2) nonproliferative DI; (3) proliferative DI. The sensitivity of biomicroscopy in detecting DI turned out to be 57%, while the specificity was 94%. The positive predictive value was 93% and the negative predictive value 50%. Our study proved that biomicroscopy can accurately judge when DI is absent. When it is present, however, there is a high probability that biomicroscopy will be less precise in the detection of iris lesions.

Aged↗

Fundus fluorescein angiography of patients with severe hypertensive nephropathy.

PURPOSE: To analyze the fluorescein angiograms of patients with hypertensive renal failure. METHODS: Fluorescein angiograms were obtained of 34 patients with hypertensive renal failure. The glomerular filtration was less than 20 ml/min in each patient. RESULTS: Capillary nonperfusion and a coarse retinal capillary bed are the hallmark of the hypertensive retinopathy. Tortuous retinal arterioles or tortuous retinal arteriovenous anastomoses are observed. It is suggested that capillary collaterals shunt arteriolar obstructions or short-cut nonperfused capillary beds; these remodel into tortuous arterioles or arteriovenous anastomoses with regular caliber. Elschnig spots and delayed choroidal filling are signs of hypertensive choroidopathy. Depigmentation spots of the retinal pigment epithelium without a central pigment clump are considered atypical Elschnig spots. CONCLUSIONS: Retinal pigment epithelial changes are permanent scars of hypertensive choroidopathy, while coarse retinal capillary bed and tortuous retinal arterioles or arteriovenous anastomoses are the result of hypertensive retinopathy in these patients with hypertensive renal failure.

Adult↗

Specific reactivity of fluorescein isothiocyanate-conjugated separated IgG and IgA from celiac disease sera on human tissues.

Study of the reaction of celiac disease-related antibodies with human substrates has been hampered by the immunological cross-reactivity between fluorescein isothiocyanate-conjugated anti-human immunoglobulins and immunoglobulins normally present in human tissues. In order to overcome this problem we extracted IgG from 2 celiac disease sera (positive for specific IgG and IgA antibodies) using a genetically engineered recombinant form of streptococcal protein G covalently immobilized on 4% agarose beads. The separated IgG and IgA was conjugated with fluorescein isothiocyanate and used in direct immunofluorescence on 0 blood group human duodenum, liver, and myocardium. Staining of the lamina propria beneath the villous epithelium, the endomysium of smooth muscle layers in the duodenum, and the liver sinusoidal and pericellular myocardial matrix was observed. The reactivity of celiac disease-related antibodies with various human tissues indicates that these antibodies are the result of a systemic immune response directed against all tissues containing matrix proteins.

Animals↗

Mycoplasma detection in cell culture by concomitant use of bisbenzamide and fluoresceinated antibody.

Conditions are presented for application of both bisbenzamide (Hoechst 33258) stain and a specific fluoresceinated anti-Mycoplasma hyorhinis IgG to a single cell culture preparation. This allows the same field on a slide to be viewed for presumptive diagnosis of any cell culture contaminant mycoplasma by bisbenzamide staining and for definitive diagnosis of M. hyorhinis strains using fluoresceinated antibody. The use of this method plus a cultural procedure will permit identification of the "noncultivable" M. hyorhinis strain DBS 1050.

Animals↗

Passing of fluorescein derivatives into the hyphae of Phanerochaete chrysosporium.

Fluorescein derivatives added into the growth medium were decolorized during submerged cultivation of Phanerochaete chrysosporium. The highest decrease of absorbance A450 was observed in the growth phase regardless of the presence of inducers Tween 80 or poly(ethylene glycol) (PEG). Fluorescein linked to PEG was prepared and, after addition to cultures, shown to stimulate the production of lignin peroxidase. Passing of fluorescing substances into hyphae (observed by confocal microscopy) showed that they were concentrated on some structures inside hyphae.

Culture Media↗

[Central serous chorioretinopathy. Clinical, fluorescein angiography and demographic aspects].

UNLABELLED: The purpose of this retrospective study was to analyze the demographic characteristics of central serous chorioretinopathy (CSC). METHODS: Findings of 100 consecutive subjects with CSC were evaluated. Clinical and fluorescein angiographic findings, demographic characteristics, and visual acuity were analyzed. RESULTS: The age of the patients ranged from 28 to 68 years with a mean of 43 years. No significant sex differences were found concerning age and other parameters. The highest age peak was in the group of women. The male to female ratio was 5:1. Patients with chronic CSC were significantly older (P = 0.015) than patients with the other angiographic findings. Median visual acuity was 0.5. In 40% bilateral characteristics of CSC were found. Clinical and fluorescein angiographic findings showed no significant correlation with visual acuity. CONCLUSION: The range of age distribution in CSC is wide. In older patients distinguishing CSC from age-related macular degeneration can be difficult.

Adult↗

Indocyanine green and fluorescein hyperfluorescence at the site of occlusion in branch retinal vein occlusion.

BACKGROUND: In patients with branch retinal vein occlusion (BRVO), we investigated the presence of indocyanine green (ICG) and fluorescein hyperfluorescence at the site of occlusion. We also assessed the association of this feature with the clinical outcome of these patients. METHODS: Both indocyanine green (ICG) videoangiography and fluorescein angiography (FAG) were performed in 21 eyes with BRVO of less than 1 month duration. Deterioration of the disease was defined clinically as an increase in retinal hemorrhages or retinal edema. Capillary nonperfusion was quantified with computer image analysis from the FAG pictures. RESULTS: ICG videoangiography showed focal hyperfluorescence along the venous wall at the site of the affected A-V crossing in 9 of the 21 eyes, and FAG showed this feature in 10 eyes. The ICG hyperfluorescence was more prominently and focally detected than the hyperfluorescence on FAG, which was sometimes diffusely seen throughout the whole occluded area. Eight of the nine eyes showing ICG hyperfluorescence had clinical deterioration with an increase in retinal hemorrhage or edema. This deterioration occurred more frequently in eyes with hyperfluorescence and/or late leakage than in ones without these features. The mean nonperfused area was significantly larger in eyes with hyperfluorescence than in eyes without these features. CONCLUSION: The ICG hyperfluorescence at the site of A-V crossing is associated with disease deterioration in patients with fresh BRVO. The ICG hyperfluorescence was more easily detectable than the hyperfluorescence on FAG, although the difference in sensitivity between the two methods is not great.

Adult↗