Slow versus Rapid Fluorescein Injection in Angiographic Studies for Retinal Vascular Disorders

PURPOSE To compare the incidence of adverse reactions following rapid versus slow fluorescein injection for fundus angiography. METHODS This randomized controlled trial was performed on 500 patients with retinal vascular disorders. Subjects with central serous retinopathy, age-related macular degeneration and retinal pigment epithelial changes were excluded. Pregnancy, asthma, allergic diseases and previous history of reactions to fluorescein were other exclusion criteria. Patients were randomly divided into two equal groups who received slow infusion of dye (over 15-25 seconds) versus the usual rapid injection (in 5-8 seconds), and were compared for adverse effects. RESULTS Overall, 47 (9.4%) patients including 34 (13.6%) subjects in the rapid group and 13 (5.2%) cases in the slow group developed adverse reactions (P=0.001, relative risk=2.6). All adverse reactions were categorized as mild; no instance of moderate or severe reactions was observed. There was a lower incidence of nausea and vomiting with slow infusion of fluorescein (P=0.02), however no statistically significant difference was observed in the frequency of vertigo and vasovagal reactions between the study groups. CONCLUSION Slow fluorescein injection during fundus angiography, instead of the usual rapid application, can be an effective way to reduce the incidence of nausea and vomiting in patients whose first phase of angiography is of little diagnostic importance.