Stuart:
Ok. I understand your point about “thehighest level testing results”. We all do.
But, for the record, I have beenperforming Fluorescein Angiographies for the
past 44 years. That is close to100,000 FAs during my professional career. In
that period of time, I've had themishap of beating the odds (the manufacturer’s
published data that comes along theprinted literature that accompanies the
pharmaceutical product). That meansthat two deaths have occurred during an FA
procedure. I am certain that other ophthalmicphotographers have had that happen
to them too. Therefore, I would not likethat to happen again to me, nor to
anyone else in the profession. That is why Ihave implemented those injection
rate changes that I would like to address.
I am aware that death is a subject matterthat practically no one would like to
publicly address, due to the risks of thelegal implications. But, Optimal and
OPS should be concerned with patientsafety first, versus high quality images.
Any one out there willing to expresstheir opinions on this important matter?
Regards to all.
Hector Mendez Caratini, CRA
On Friday, March 10, 2017 11:10 AM, Hector Mendez Caratini
<dmarc-noreply@xxxxxxxxxxxxx> wrote:
Dear Coy and fellow ophthalmic photographers:
I would like to address a new safety concern topic:
It is not comfortable for the patient torapidly inject (in less than 2 to 3
seconds) a bolus of 5cc 10% fluorescein dye andhave him /or her vomit on you
past the 30 seconds mark. It happens too frequently.More than you would like it
to happen.
With the newer acquisition equipment (andold ones too, such as Topcon TRC
50’s), which are much more sensitive, I havebeen using the following technique.
To reduce the possibilities of adversereactions (nausea, vomiting, urticaria,
cardiac arrest and even death!), what Ihave been doing is injecting half the
dose that comes inside the vial (itdoesn’t matter if it is 10% or 25%, light or
dark). It has worked very well forme. With practically NO allergic reactions a
year, versus a lot monthly ones.You still can get an excellent Early Phase and
Mid Phase fluorescein transit.Where you can easily identify the leaking
pathology. Sometimes, the Late Phase(past seven minutes) images look a bit
washed out. But, if you’re taking intoconsideration patient comfort and safety,
it’s very well worth the dose.
Another positive side to this equation isthat you’re reducing the monetary
costs of the study. That is one vial for twopatients. It is nice to obtain high
quality exhibition grade images. But,please remember that patient safety should
always be our main concern. Putyourself (or your dear family member) inside the
patient’s shoes.
Hector Mendez Caratini, CRAPuerto Rico
On Friday, March 10, 2017 9:47 AM, "Egnatz, Thomas" <tegnatz@xxxxxxxxx>
wrote:
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div.yiv4550854824WordSection1 {}#yiv4550854824 I am posting this for Coy.
Sorry about the delay, I have been off Optimal for a month (new computer). Tom
From: Cobb, Coy, VHACIN
Sent: Thursday, February 16, 2017 9:22 AM
To: 'optimal@xxxxxxxxxxxxx'
Subject: 10% vs 25% Fluorescein Morning all Would anyone know of any
studies comparing 5cc’s of 10%, verses 3 cc’s of 25% fluorescein ?
Specifically, I’m looking for anything that addresses adverse reactions. Coy
Cobb COT CRA
