Researchers recently found that fasting oral fluorescein angiography (FA) yielded images of significantly better quality at a faster, more optimal rate when compared with non-fasting oral FA.

This observational, case-crossover study evaluated 160 eyes of 80 patients undergoing routine oral FA for retinal disease. Experienced retina specialists obtained fasting and non-fasting images of the same patient and compared them for different image quality parameters and clinical relevance.

The researchers found they achieved better angiography quality scores for the images taken when patients were fasting compared with images taken when they were not. They note that non-fasting patients with higher body mass indexes had the worst scores. The identification of other clinical parameters, such as drusen staining, disciform scar staining and central and peripapillary atrophy, was also significantly better during the pre-fasting exam, they add. As for test speed, the researchers obtained quality images approximately 22% faster (time to fluorescein dye appearance) when patients had fasted compared with non-fasting (18.7±6.9 minutes vs. 25.14±8.1 minutes).

“By improving its overall quality, oral FA could be a useful adjunctive examination to optical coherence tomography (OCT) and OCT angiography in patients who require FA studies but who have difficult access or refuse an invasive procedure,” the study authors concluded.

Amador-Patarroyo MJ, Lin T, Meshi A, et al. Identifying the factors for improving quality of oral fluorescein angiography. Br J Ophthalmol. July 4, 2019. [Epub ahead of print].