Eye Angiography (FFA and ICG)

Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICG) are photographic tests of the blood circulation at the back of the eye. A dye is injected into a vein in your arm, and a special camera takes a timed series of pictures as it flows through the vessels of the retina and the deeper choroid.

Fluorescein highlights the retinal vessels and shows leakage and closed capillaries. ICG uses near-infrared light to see the choroidal circulation beneath the retina. No X-rays are involved. The tests guide treatment decisions but do not treat anything themselves.

What Eye Angiography (FFA and ICG) shows

FFA shows where retinal vessels leak, where capillaries have closed and where abnormal new vessels are growing. It is used in diabetic retinopathy, retinal vein and artery occlusions, wet macular degeneration, inflammation of the retinal vessels, central serous retinopathy and some tumours. ICG is particularly useful for polypoidal choroidal vasculopathy, a variant of wet macular degeneration more common in Asian and African patients, for chronic central serous retinopathy, for choroidal inflammation in uveitis and for choroidal haemangioma. Widefield cameras show the outer retina, which helps in planning laser for diabetic disease.

When Eye Angiography (FFA and ICG) is recommended

• Suspected wet macular degeneration when OCT findings are unclear
• Diabetic retinopathy where areas of capillary closure or new vessels need mapping
• Retinal vein occlusion, to judge the degree of ischaemia
• Uveitis and retinal vasculitis, to measure activity and response to treatment
• Central serous retinopathy that persists, before laser or photodynamic therapy
• Unexplained visual loss with a normal-looking retina

Limits and situations where another test is better:

• Routine monitoring of macular disease, where non-contact OCT and OCT angiography now answer most questions without dye
• Previous serious reaction to fluorescein or ICG; ICG is avoided with iodine or shellfish allergy
• Pregnancy, when the tests are usually postponed unless essential
• Severe kidney failure or liver disease, which call for caution with fluorescein and ICG respectively
• Dense cataract or blood in the eye, which blocks the view

How to prepare

• Eat a light meal beforehand; fasting is not required
• Bring a list of medicines and allergies, and mention asthma or previous dye reactions
• Arrange not to drive, since your pupils will be dilated for 4 to 6 hours
• Bring sunglasses
• Remove contact lenses

What happens during the test

Dilating drops are given and take about 20 to 30 minutes to work. A small cannula is placed in a vein of your arm or hand. You sit at the camera with your chin on a rest; baseline photographs are taken, then the dye is injected over a few seconds. Rapid flashes follow for the first minute, then pictures at intervals for 10 minutes with fluorescein and up to 30 minutes with ICG. A brief wave of nausea or warmth about 30 seconds after fluorescein is common and passes within a minute or two.

Results and next steps

Images are available immediately and the ophthalmologist usually reviews them with you the same day, often alongside an OCT scan. The result typically leads to a decision: observation, anti-VEGF injections, laser to specific areas, photodynamic therapy or a change in uveitis medication. Ask for a digital copy of the images and the report to take home to your own eye doctor.

• Test time: 30 to 45 minutes plus dilation
• Results ready: Same day
• Back to everyday activity: Blurred, light-sensitive vision for 4 to 6 hours

Safety and risks

• Temporary yellow tinge to the skin and bright yellow-orange urine for 24 to 36 hours after fluorescein
• Nausea in up to about 1 in 10 people, vomiting less often
• Itching or hives, treated with antihistamine
• Dye leaking under the skin at the injection site, causing local pain
• Fainting
• Severe allergic reaction (anaphylaxis), rare at roughly 1 in several thousand to tens of thousands; the unit must have resuscitation equipment to hand

Arranging Eye Angiography (FFA and ICG) in Türkiye

Nobody travels for an angiogram alone. It earns its place as part of a retinal work-up or second opinion, or on the same day as planned treatment such as laser. If you already have recent angiography or OCT images from home, bring them on a disc or as files, since repeating a dye test is not always necessary. It adds about an hour to a clinic visit and does not affect when you can fly.

Send your previous reports and the question you want answered and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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