Fluorescein angioscopy with interpretation and report
CPT4 code
Name of the Procedure:
Fluorescein Angiography (FA), also known as Fluorescein Angiography with Interpretation and Report
Summary
Fluorescein Angiography is a diagnostic test used to capture images of the blood vessels in the retina, identifying abnormalities in the eye. It involves injecting a fluorescent dye into the bloodstream and taking photographs of the retina as the dye passes through its blood vessels.
Purpose
The procedure is primarily used to detect and monitor various retinal conditions such as diabetic retinopathy, macular degeneration, or retinal vein occlusion. The goal is to visualize blood flow, identify leaks or blockages, and guide treatment strategies to prevent vision loss.
Indications
- Sudden vision changes
- Diabetic retinopathy diagnosis and management
- Age-related macular degeneration
- Retinal vascular diseases
- Unexplained vision loss
- Monitoring the efficacy of retinal treatments
Preparation
- Inform the doctor about all medications and allergies.
- Patients may need to fast for a few hours before the procedure.
- An initial eye exam may be conducted.
- Consent forms will be signed after a detailed discussion with the healthcare provider.
Procedure Description
- The patient is seated, and eye drops are administered to dilate the pupils.
- A small amount of fluorescein dye is injected into a vein in the arm or hand.
- As the dye travels through the bloodstream and reaches the retinal blood vessels, a series of photographs are taken using a specialized camera.
- The entire imaging process usually takes around 10 minutes, capturing detailed views of the retinal blood vessels and helping to identify any abnormalities.
Duration
The procedure itself typically takes about 10-15 minutes, but the entire visit may take up to an hour, including preparation and post-procedure assessment.
Setting
Fluorescein Angiography is usually performed in an ophthalmologist's office or an outpatient clinic equipped with the necessary imaging technology.
Personnel
- Ophthalmologist or Retina Specialist
- Trained Ophthalmic Technician or Nurse
Risks and Complications
- Mild allergic reactions to the dye (nausea, vomiting, skin rash)
- Rare severe allergic reactions (anaphylaxis)
- Temporary yellowing of the skin and urine (naturally resolves in 24-48 hours)
- Temporary blurry vision due to dilated pupils
Benefits
- Accurate diagnosis of retinal conditions
- Effective monitoring of disease progression and treatment response
- Prevention of vision loss through timely and targeted treatment interventions
- Immediate results for fast decision-making
Recovery
- Patients may experience mild discomfort and blurred vision for several hours due to dilated pupils.
- Avoid bright lights and wear sunglasses.
- Drink plenty of fluids to help flush the dye from the body.
- Normal activities can typically be resumed the same day.
- Follow-up appointments may be scheduled to discuss the results and next steps.
Alternatives
- Optical Coherence Tomography (OCT): Uses light waves for detailed cross-sectional images of the retina but does not show blood flow.
- Indocyanine Green Angiography (ICG): Similar to FA but uses a different dye, often for distinguishing choroidal abnormalities.
- Observation and Regular Eye Exams: For less severe conditions, regular monitoring without immediate angiographic imaging.
Patient Experience
During the procedure, patients may feel a slight sting or pinch from the dye injection. The bright lights from the camera might be uncomfortable, but the process is usually painless. Post-procedure, patients often notice temporary yellowing of the skin and urine and might feel some mild nausea or lightheadedness, all of which generally resolve quickly. Pain management and comfort measures, like avoiding bright environments and staying hydrated, will help ensure a smoother recovery process.