Adverse reactions to fluorescein angiography: A comprehensive review of the literature

• Published in: Survey of ophthalmology 2019-09, Vol.64 (5), p.679-693
• Main Authors: Kornblau, Ilyse S., El-Annan, Jaafar F.
• Format: Article
• Language: English
• Subjects: adverse reactions; allergy; anaphylaxis; Contrast Media - adverse effects; Drug Hypersensitivity - epidemiology; drug toxicity; Fluorescein - adverse effects; fluorescein angiography; Fluorescein Angiography - adverse effects; Fundus Oculi; Global Health; Humans; Incidence; medication reactions; Retinal Diseases - diagnosis
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/j.survophthal.2019.02.004

We reviewed literature on adverse reactions to intravenous fluorescein angiography using PubMed and found 78 articles in English from 1961 to 2017. The reported rates of adverse reactions were overall 0.083–21.69%, separated into mild (1.24–17.65%), moderate (0.2–6%), and severe (0.04–0.59%). There were 1:100,000 to 1:220,000 deaths. Fluorescein concentration, volume injected, speed of injection, temperature, and contaminants were not correlated with the incidence of reactions. Patient characteristics including other comorbid diseases, allergy history, age, race, and gender showed only an increased rate of reaction in patients with a history of reaction to fluorescein. Although a number of studies examine techniques to reduce adverse reactions to intravenous fluorescein angiography, to date, the only proven method is reviewing allergy history, specifically a history of previous reaction to fluorescein.