Adverse Effects of Fluorescein Angiography

Intravenously injected sodium fluorescein is generally tolerated without any major problems. Possible side effects can be classified as mild (approximately one in 20 to one in 100 angiographies), moderate (approximately one in 60), and serious (approximately one in 2000).

Fatalities have been reported in at least seven cases immediately after fluorescein angiography, and a frequency of one in 220 000 has been calculated.

The incidence of adverse effects appears to have decreased in recent years due to the availability of better fluorescein preparations.

In practice, the most common side effect observed is nausea some 30 s after injection. This is generally self-limiting, but it often coincides with the important phase of arteriovenous transfer and, because of resultant restricted photographic conditions, can seriously reduce the quality of the angiography.

However, despite the rarity of serious side effects, the physician supervising an angiography must be able to recognize serious emergencies and provide appropriate treatment.

Oral administration of fluorescein has been suggested as an alternative method; however, an anaphylactic reaction after oral administration has also been observed.

Adverse Effects of Indocyanine Green Angiography

Intravenously injected indocyanine green (ICG) is generally tolerated without any major problems. Adverse effects can be classified as mild (0.15–0.26% of ICG angiographies), moderate (0.2% of ICG angiographies), or serious (0.05% of ICG angiographies).

Nausea is less frequent than with fluorescein angiography.

Anaphylactic shock has been reported in some patients.