Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral
CPT4 code
Name of the Procedure:
Fluorescein Angiography and Indocyanine-Green Angiography (includes multiframe imaging)
Summary
Fluorescein angiography (FA) and indocyanine-green angiography (ICGA) are imaging tests that use special dyes and cameras to take pictures of blood flow in the retina and choroid, layers in the back of the eye. These tests can be performed on one or both eyes during the same appointment, and a detailed interpretation and report are provided by a specialist.
Purpose
These procedures help in diagnosing and monitoring various eye conditions such as macular degeneration, diabetic retinopathy, and other retinal or choroidal diseases. The goal is to identify abnormalities in blood vessels that may affect vision and to guide treatment decisions.
Indications
- Blurred or distorted vision
- Unexplained vision loss
- Diabetic retinopathy
- Age-related macular degeneration (AMD)
- Retinal vein occlusion
- Suspected retinal or choroidal tumors
- Inflammatory or infectious diseases of the retina
Preparation
- Patients may be advised to avoid eating for a few hours before the test.
- They should inform their doctor about all medications and any allergies, especially to dyes.
- Baseline eye examination and possibly other imaging tests may be performed beforehand.
Procedure Description
- Preparation: The patient receives dilating eye drops to widen the pupils.
- Injection: A small amount of fluorescein dye is injected into a vein in the arm, followed by indocyanine-green dye.
- Imaging: As the dyes travel through the blood vessels in the eye, a special camera takes multiple images over several minutes.
- Monitoring: The eye care specialist monitors the patient for any immediate allergic reactions.
Tools/Equipment Used: A special camera system equipped for both fluorescein and indocyanine-green imaging.
Anesthesia: No anesthesia or sedation is typically required.
Duration
The procedure usually takes about 30-45 minutes.
Setting
This procedure is typically performed in an outpatient clinic or an eye care specialist's office.
Personnel
- Ophthalmologist or retinal specialist
- Ophthalmic technician
- Nurse (for dye injection and monitoring)
Risks and Complications
- Mild nausea or vomiting
- Allergic reactions to the dyes, ranging from mild itching to severe anaphylaxis (rare)
- Temporary yellowing of the skin and urine due to fluorescein
- Bruising at the injection site
Benefits
- Accurate diagnosis of retinal and choroidal conditions
- Detailed imaging helps in planning appropriate treatment
- Early detection of abnormalities leading to timely intervention
Recovery
- Patients can resume normal activities shortly after the test.
- Temporary blurriness or sensitivity to light due to dilated pupils may occur.
- Follow-up appointments may be necessary based on the findings.
Alternatives
- Optical coherence tomography (OCT)
- Ultrasound of the eye
- Magnetic resonance imaging (MRI) of the eye
Pros of Alternatives: Non-invasive options may be preferable for certain patients.
Cons of Alternatives: May not provide the same detailed information about blood flow and vessel integrity.
Patient Experience
During the procedure, patients might experience a brief sting from the dye injection and some discomfort from the bright camera flashes. Post-procedure, most patients feel normal but might have temporary visual disturbances. Pain management typically isn't required, but patients are advised to wear sunglasses to mitigate light sensitivity.