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Fluorescein Sodium What Is It?

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Fluorescein Sodium What Is It? 62 Journal of Ophthalmic Photography Vol. 14, No. 2 December 1992 Fluorescein Sodium What is it? Jeff Jacobs, CRA Angiography Services, and Eye Specialist of Nebraska, Hastings, NE Fluorescein sodium is an important diagnostic tool in In its finished form, the dye has a pH range of 8.0 to the ophthalmic community today. As ophthalmic pho- 9.8 which means it is a strong alkali. 4 Alkalis are tographers we need to understand what this substance substances whose pH is greater than 7, while acids are is, how it works, and correctly inform patients about it. less than 7. Both acids and alkalis may cause tissue Many substances give off light when excited by heat damage. The manufacturers inserts in each package of energy or electromagnetic radiation. When a substance injectable dye do, in fact, warn against extravasation of emits light during excitation of its atoms by light the dye because the alkalinity can cause tissue damage. energy, i.e., the atoms absorb the energy of the light, When the solution is made neutral or acidic it loses its and stops the release of light when the excitation fluorescent property. ceases, the light emitted from the substance is called There are other forms of fluorescein than the sodium fluorescence. The fluorescein dye molecules during an salt which we use, but they are not notable for their angiogram absorb the incoming blue light energy, rais- fluorescence. Bright dyes such as rose bengal and eo- ing the electrons to a higher energy level. Immediately sine are also derivatives of phthalic anhydride and after the exciting light ceases, the electrons release the resorcinol, but in combination with other substances extra energy absorbed and drop back to their original such as bromine or iodine instead of sodium. Fluores- energy level. That we can see and photograph minute cein sodium is very potent, that is, it fluoresces brightly, details of an eye from this released light we call fluores- and has been reported as being detectable in dilutions cence is due to the properties of the interesting sub- as great as 1:40,000,000. 5 As with most other inject- stance we call fluorescein sodium. able solutions it is available by prescription.6 Fluorescein sodium, or sodium fluorescein, is also Used since its discovery in 1871 in activities as known as uranine, resorcinolphthalein, or DC Yellow varied as medicine, exploring caves, and measuring #8, and is a dye made principally from two petroleum water flow, fluorescein sodium has become a major products called resorcinol and phthalic anhydride.) Petroleum is an oily substance, naturally occurring, part of the modern ophthalmic armamentarium. composed mainly of a mixture of gaseous, liquid, and solid hydrocarbons. Resorcinol is a member of the phenol group of chemicals extracted from this mix- REFERENCES ture. 2 Phthalic anhydride is synthesized from naphtha- 1. Remingtons Pharmaceutical Sciences, 17th Ed. 1985. Mack Pub- lene, another petroleum component, in the presence of lishing Co., Easton, Pa., pg. 1275. a catalyst at almost 500 degrees Celcius. 3 Each of these 2. McGraw Hill Encyclopedia of Science and Technology, 6th Edi- two substances is used in combination with other chem- tion. 1987. McGraw Hill Book Company, New York. 15:390. icals to form stable compounds, including plastics, 3. McGraw Hill Encyclopedia of Science and Technology, 6th Ed. 1987. McGraw Hill Book Company, New York. 13:447. which are used in everyday life. 4. Des Rochers, G.E., letter to author dated June 28, 1990 The dye is manufactured by mixing seven parts of 5. Encyclopedia Britannica. 1972. William Benton, Chicago. 9:495. resorcinol with five parts of phthalic anhydride at 195 4 6. PDR for Ophthalmology 1990, Medical Economics Co. Inc., degrees Celcius. It is boiled, filtered, precipitated, refil- Oradell, New Jersey. tered, dissolved, reprecipitated, and purified—a pro- cess done in several steps and with several solutions, most notably sodium hydroxide, so that at the end of Acknowledgments: Barry D. LeBlanc, President of Akorn, Inc., and the process it is a pure substance that may be used to G.E. Des Rochers, Technical Director of Walnut Pharmaceuticals, Inc., for their interest in this paper and their contribution of exper- make the injectable solution, a topical solution, or tise. dye-impregnated paper strips. Water, sodium hydrox- ide, and/or hydrochloric acid, are added to the dye powder to make the injectable form. Key words: Fluorescein Sodium, resorcinol, phthalic anhydride.
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