[optimal] Re: Question on fluorescein dosages

  

So Ethan, you are using some type of stopcock for separate injections?
Why would that be an advantage, if the FA arrives first, does it really
make that much difference to have a bolus for the ICG?

 

Inquiring minds wish to know....

 

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

From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
On Behalf Of Ethan Priel
Sent: Saturday, February 05, 2011 5:20 AM
To: optimal@xxxxxxxxxxxxx
Subject: [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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