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Paediatric information Fluorescein (FFA) and indocyanine green (ICG) angiography What is fluorescein (FFA) and indocyanine green (ICG) angiography? These are simple diagnostic tests, which involve the injection of fluorescein (yellow) dye and/or indocyanine green into the bloodstream via a vein in the hand or arm, followed by a series of photographs taken over several minutes. Your child can take all of their current medication as normal on the day of the procedure. They may also eat and drink as normal. An FFA test gives the doctor more information about the condition of your child’s retina, the light-sensitive layer, at the back of their eye. You will be asked about their general health. Please tell us if they have any history of chest or breathing problems. It is also very important to inform us of any allergies they may have, particularly to shellfish, iodine, medications, fluorescein, sulpha drugs or latex. The ICG test provides information about the choroid, the layer of blood vessels, underneath the retina. These tests will help the doctor to consider and then discuss with your child and yourself the best treatment options. Moorfields Eye Hospital NHS Foundation Trust City Road, London EC1V 2PD Phone: 020 7253 3411 www.moorfields.nhs.uk What does the test involve? On arrival at the outpatient department, your child’s vision may be tested. Your child’s pupils will then be dilated with eye drops. These drops might blur their vision. You will have the procedure explained to you and you will be asked to sign a consent form to agreeing to the procedure. Please feel free to ask any questions at this point. Once your child’s pupils are dilated, they will be taken into the fluorescein photography room. You will be allowed to accompany them during the procedure. Your child will be required to sit in front of a camera and some photos will be taken of the eye before the procedure begins. A cannula (small plastic tube) will be inserted into a vein (usually in the back of their hand). This should be relatively painless as they will be given some numbing cream beforehand. The fluorescein dye and/or indocyanine green will be injected into the cannula while a series of photos are taken as the dye enters the vessels at the back of their eye. The whole test takes about 10-30 minutes, but please expect to be in the department for one to two hours to allow for the necessary pre- and post-test checks. It is very important for your child to keep their eye in the position requested by the Moorfields Eye Hospital NHS Foundation Trust City Road, London EC1V 2PD Phone: 020 7253 3411 www.moorfields.nhs.uk photographer. This will be clearly explained during the procedure. Are there any side effects? The fluorescein dye will give the skin a yellow tinge and your child’s urine will be bright yellow for one or two days. The ICG procedure does not lead to any permanent changes to skin or urine colour. They might experience a hot flush sensation as the dye is injected. One in 10 patients may feel nauseous or short of breath, or develop a brief rash, but this rarely lasts for more than a few seconds. There is a very remote risk of a severe allergic reaction to these and any intravenous drugs causing shock and collapse. For this reason, an emergency resuscitation team is always available. After the fluorescein angiogram The cannula will be left in their hand for half an hour. Once we are certain that they have not suffered any adverse reactions, it will be removed. The doctor will discuss the results with you and make recommendations for any treatment they might need. Author: Dr Matthew Allen, consultant anaesthetist Revision number:1 Approved: April 2016 Review date: April 2018 Moorfields Eye Hospital NHS Foundation Trust City Road, London EC1V 2PD Phone: 020 7253 3411 www.moorfields.nhs.uk Moorfields Direct telephone helpline Phone: 020 7566 2345 Monday-Friday, 9am-9pm Saturday, 9am-5pm Information and advice on eye conditions and treatments from experienced ophthalmic-trained nurses. Patient advice and liaison service (PALS) Phone: 020 7566 2324 or 020 7566 2325 Email: [email protected] Moorfields’ PALS team provides confidential advice and support to help you with any concerns you may have about the care we provide, guiding you through the different services available at Moorfields. The PALS team can also advise you on how to make a complaint. Moorfields Eye Hospital NHS Foundation Trust City Road, London EC1V 2PD Phone: 020 7253 3411 www.moorfields.nhs.uk Your right to treatment within 18 weeks Under the NHS constitution, all patients have the right to begin consultant-led treatment within 18 weeks of being referred by their GP. Moorfields is committed to fulfilling this right, but if you feel that we have failed to do so, please contact our patient advice and liaison service (PALS) who will be able to advise you further (see above). For more information about your rights under the NHS constitution, visit www.nhs.uk/choiceinthenhs.