ROLE OF FUNDUS FLUORESCEIN ANGIOGRAPHY IN EVALUATION OF RETINAL DISORDERS

BACKGROUND Retinal disorders are the leading cause of legal blindness in the age group of 20 to 65 years. Approximately 18 million people in India have severely impaired vision due to retinal diseases. It has been nearly 40 years since the principle and technique of fluorescein angiography were first described. The procedure has now become standardized and has found a regular place in routine diagnosis of fundus disorders. This study was undertaken to assess and evaluate the role of fluorescein angiography and underline its advantages over other conventional methods of ophthalmoscopy in the evaluation of posterior segment diseases. MATERIALS AND METHODS A prospective study was done which included 40 patients who attended the OPD during the study period. Detailed history was taken from the patient and a thorough ocular and systemic examination was done. All patients were examined by conventional methods of ophthalmoscopy (CO) followed by a fluorescein angiography. Patients were advised necessary ocular and systemic treatment. Patient was referred to a vitreo-retinal surgeon (whenever indicated). RESULTS 40 cases were analysed and sub-divided into 3 categories of macular disorders, retinal vascular disorders and inflammatory conditions. FA altered the diagnosis in 13.34%, 50% and 12.5% cases while categorized the lesions in 53.34%, 12.5% and 62.5% cases respectively. Incidence of side effects was 22.5% of which nausea (44.5%) and vomiting (22.25%) were the most common. Incidence of side effects was similar in all age groups, both the sexes with no gender bias and no predilection for cases with known history of drug allergy. On statistical analysis, FA proved to be a far superior diagnostic modality. CONCLUSION FA can help to detect cases beyond the reach of clinical ophthalmoscopy. FA is of immense value in diagnosing new vessels, planning for photocoagulation and categorization of lesions. CO has a good positive predictive value, but it has a low negative predictive value. Therefore, clinically negative cases should be advised FA. FA is a safe procedure with minor side effects. Nausea and vomiting being most common.