[optimal] Re: Question on fluorescein dosages


Denice-

There are indeed different dosages for different purposes of ICGA.

 

For example, for locating feeder vessels one can use a fraction of the 25mg
in the vial, since often times 2-3 angiographies are in order for the
morning, and with the small amount the background fluorescence fades by the
time the second angiography is needed.

 

For choroidal inflammatory diseases we need more of the late-stage photos,
so larger doses are used.

 

In general we use the  whole vial in most cases.

 

Regarding the simultaneous bolus vs. separate, here too the nature of the
study dictates the mode of injection.

 

Unless the pathology indicates that simultaneous angiography would be
beneficial, I employ the separate method, and perform simultaneous frames
during the study.

Fluorescein precedes ICG injection by 2-3 minutes, which is very efficient,
and there are many benefits to injecting Fluorescein first.

 

All the best,

 

Ethan

 

From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of CPMC Ophthalmic Diagnostic Center
Sent: 04 February, 2011 18:19
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Question on fluorescein dosages

 

Dear Optimal Tribe

 

Am looking for publication, survey, etc on the merits of Simultaneous FA/ICG
cocktail

 

Interesting citations going back to 1999-2001 about correct dosages.  I see
one here out of Argentinausing 500mg CA and 12.5 mg of ICG in bolus.   Can
that be right?

 

We’re using 2 cc’s 25% FA ( 250mg/ml) and 4.5 cc reconstituted ICG in same
syringe.  Works great.

 

Retina docs telling me we must go back to old school of separate bolus,
stopcock, separate syringes.  Wouldn’t that defeat the purpose of
SIMULTAENOUS FA/ICG?  

 

Citation in “Ophthalmic Photography” Saine, Tyler “for simultaneous FA/ICG
dosages of the two dyes are combined in the same syringe”.  Exact dosages
not mentioned.

 

I’d sure like to have a stronger argument than empirical evidence visa vis
great photos on the Spectralis to make my case.

 

Thanks

Denice

 

 

 

Denice Barsness, CRA, COMT, ROUB, FOPS

Ophthalmic Diagnostic Center

CPMC Department of Ophthalmology

2100 Webster Street Suite 212

(415) 600-3937   FAX (415) 600-6563

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