I would agree with Stephen. I've never done an FA for disc drusen, usually
OCT with AF or B scan. 13/14 years old also seems old enough to try IVFA
first as oral FAs don't do as well with the transit phase.
*Katie Lachut *| (315)806-9733 | https://www.flickr.com/photos/katielachut
Ophthalmic Photographer with VCU Health System | RIT 2013
On Wed, Oct 10, 2018 at 12:33 PM Stephen Travers <stravers@xxxxxxxxxx>
wrote:
Hi Stuart
It’s been a long time since I have been in the clinic, however as I recall
the most appropriate imaging procedure for disc drusen would be OCT and B
Scan ultrasound. If there is truly drusen present you will see them clearly
using these imaging technologies. As far as FA is concerned I would opt for
IV administration as this method will give you a phased angiogram that you
will not get with oral. As you are using a Spectralis and the patient
weight is only 100 lbs I believe that you should get an acceptable FA with
2.5ml of 10%. I do not however that an FA will be very helpful unless you
are trying to identify transient optic disc ischemia and if so then the IV
route will provide a better chance of seeing this ischemia if present.
Hope this helps
Stephen
-----------------------------------------------------
Stephen Travers
Senior Director of Clinical Research
EyeKor Inc.
6527 Normandy Lane
#100
Madison, WI 53719
www.EyeKor.com <http://www.eyekor.com/>
stravers@xxxxxxxxxx
Cell 817-716-2699
*From:* optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> *On
Behalf Of *Stuart Alfred
*Sent:* Wednesday, October 10, 2018 7:02 AM
*To:* OPTIMAL <optimal@xxxxxxxxxxxxx>
*Subject:* [optimal] More pediatric angiography questions
My satellite office is being sought out by the Riley Hospital
ophthalmology team for help with pt. testing. This is a personal
accomplishment for me. Really proud, and humbled.
Two upcoming visits:
14 year old. Weight: 100lb Working diagnosis: IIH, ON drusen
13 year old. Weight: 100lb Working Dx: ON drusen
My prescription of testing OU [stricly Spectralis FA &/ or Cirrus 5000]
would involve:
Fasting 2 hours prior
Spectralis OCT ON - ONH button [73 sec., 60ym] art at 9
ON photos - IR 30degree, RF//BR 30 deg., FAF 30 & 20 degrees
FA oral, using 10% AK-FLUOR
convert weight for admin. using referenced calculations. i.e. 2 vials
10% 5mL, into 3.5 oz. apple juice.
start timer upon pat. consuming. At 2 minutes start FA using 30 degree
lens, laser at 95% sensitivity. Acquire images every 3 minutes until 15
min. So OU at 2, 5, 8, 11, 14mins.
Any advice OPTIMAL? Please!
I don't see any reason to choose IV over oral.?
Thanks,
Stuart Alfred / 317-517-9455 / stuart.alfred@xxxxxxxxx
Board of Education - OPS {Equipment Chair} - www.opsweb.org
