[optimal] Re: No infiltration...no Fluorescein
- From: Stephen Travers <Stephen.Travers@xxxxxxxxxxxxxxxxxxxxxxxxx>
- To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
- Date: Tue, 8 Oct 2013 22:28:14 +0000
Dear Abul
If that patient had a combined CRVO and CRAO it is likely in my opinion that
you will still see dye as it enters the choroidal circulation in the early
phase of the FA as the choroid is vascularized by two separate arterial
systems, the short posterior
ciliary arteries, which supply the posterior choroid and the long posterior
ciliary arteries, which supply the anterior portion of the choroid and as these
arteries are branches of the ophthalmic artery which is the first major branch
of the internal carotid arteries I expect you will see some dye in the choroid
unless the patient has some occlusion of the carotid artery.
It would be interesting to hear other opinions on this .
Stephen Travers
Heidelberg Engineering
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of abul khair
Sent: Tuesday, October 08, 2013 12:13 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: No infiltration...no Fluorescein
I had a little question about that, If the patient had (RA&VO) retinal artery &
vain both occlusions then what?. Is it possible to see any dye in the retina?.
It is my curiosity to know.Because I have had this type of patient few days
ego,after pushing FA dye i did not see any dye in retina.
Abul Khair
senior ophthalmic photographer
Dept.of ophthalmology
BIRDEM hospital Dhaka 1000
Bangladesh.
________________________________
From: Hasan Omairah <shagroon@xxxxxxxxxxx<mailto:shagroon@xxxxxxxxxxx>>
To: Optimal Freelist <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Sent: Tuesday, October 8, 2013 10:49 PM
Subject: [optimal] Re: No infiltration...no Fluorescein
It happened to me twice so far. Both were females, diabetics, and had weight
problem.
We don’t use butterfly needles anymore –quite rarely I guess - instead a nurse
inserts an angio-cath. On both cases the line was in place and there were no
sign of leakage or extravasation. Both patients had fairly good media, with
nicely dilated pupils, their cooperation and fixation was very good though,
nevertheless No dye was visible during any stage, and I had to check the camera
in-between phases just to make sure all are OK. I used a drop from what was
left in the FA ampule, one a small piece of tissue, and another drop from
Benoxinate/fluorescein on another piece of tissue, had it in-front of the
camera and took few shots; still both fluoresce, therefore I knew the filter,
barrier, camera and flash are fine, the culprit was something else!
We have seen the patients on intervals of (1wk, 1month, 3months, and 1 year)
post injection, and they didn’t complain of any pain, skin necrosis, or any
other sign of extravasation, but strangely both experienced discoloration of
their urine, and the discoloration lasted over one day, which I believe was
consistent with the dye being pushed in ok. No skin discoloration on or near
the injection site, no swelling, or anything that is abnormal!
In our practice we use AK-Fluor - fluorescein injection 10% for so many years
and we didn’t have any problem with its stability, and both of these cases were
from two different batches. Still; normal FA’s were obtained from both batches
on different patients.
Nothing we can think of explained why no dye was visible.
Hasan
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, Hasan Omairah AAS COT OCT-C CRA
, Department of Ophthalmology MBC (97)
, King Faisal Specialist Hospital & Research Center
, PO Box 3354
, Riyadh, 11211
, Saudi Arabia
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________________________________
Subject: [optimal] No infiltration...no Fluorescein
Date: Tue, 8 Oct 2013 09:39:57 -0400
From: slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Has anyone ever experienced a phenomenon where an FA injection did not
infiltrate, or at least we did not have any indication of infiltration, and no
dye infuses into the retinal blood vessels? All camera functions we're verified
and set correctly and the Color fundus and redfree images we're good.
Just curious.
Thanks
Steve Lusk, CRA
Vistar Eye Center Retina Consultants
5296 Peters Creek Road
Roanoke, VA 24019
Phone: (540) 342-3400 ext. 4731
Fax: (540) 362-1155
slusk@xxxxxxxxxxxxx<mailto:slusk@xxxxxxxxxxxxx>
www.vistareye.com<http://www.vistareye.com/>
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