Diagnostic Role of Oral Fluorescein Angiography in Pediatric Ambulatory Clinics

Abstract

Oral ingestion of fluorescein can be done in ambulatory pediatric clinics. We show that oral ultra-widefield fluorescein angiography is a non-invasive approach to rapidly diagnose and manage a diverse set of pediatric retinal vascular diseases.

Keywords: Oral fluorescein; familial exudative vitreoretinopathy; fluorescein angiography; hemangioblastoma; pediatric retinal disease; retinopathy of prematurity; sickle cell retinopathy; ultrawide-field fluorescein angiography; uveitis.

Figure 1.. Protocol for oral fluorescein ingestion allows imaging of diverse etiologies of retinal disease.

(A) The volume of fluorescein was delivered directly to the back of the subject’s throat via a syringe, followed by ingestion of juice to ensure complete administration of fluorescein of proper concentration. Images were then taken every minute until the arteriovenous phase was visualized and then at 2-to-5-minute intervals to collect late frame images. The time of the images after ingestion are denoted in the bottom left corner of each fundus photograph. A diverse set of retinal pathology was noted and indicated in the images with white arrows. These include examples in retinal vascular diseases such as (B) familial exudative vitreoretinopathy, (C) incontinentia pigmenti, (D) intermediate uveitis, as well as systemic diseases with chorioretinal manifestations such as (E) Von-Hippel Lindau-associated retinal hemangioblastoma, (F) Sturge Weber-associated choroidal hemangioma, and (G) sickle cell retinopathy.