Information for patients and visitors

Fundus Indocyanine Green Angiography

Clinical Support Services

This booklet has been designed to give you some useful information, advice and to answer some commonly asked questions you may have.

Information for patients and visitors

Fundus Fluorescein Angiography It allows imaging of blood vessels in deeper layers than can be shown with Fundus This is a diagnostic procedure, when a dye is Fluorescein Angiography alone. injected into a in your arm or hand and sets of digital photographs are taken to This information is essential for the display the blood vessels at the back of your Consultant to find the problem and plan your eye. Its shows any abnormal blood vessels treatment. and any leaking spots causing your eye You will be asked to sign a Consent form problems. which confirms your agreement to undergo Sometimes it is combined with Indocyanine this procedure. Green Angiography (see Indocyanine Green You will be asked if you have any allergies to Angiography below). any medicines, iodine or shellfish as This information is essential for the eye Indocyanine Green dye contains Iodine. Consultant to find the problem and plan your It is carried out by experienced eye clinic treatment. medical / nursing staff and a medical You will be asked to sign a Consent form photographer. which confirms your agreement to undergo You are advised NOT to drive for the rest this procedure. of the day after you have had this You will be asked if you have any allergies to procedure and you may wish to bring a any medicines, iodine or shellfish if this pair of sunglasses with you to protect procedure is to be combined with your from bright lights / sunlight Indocyanine Green Angiography). afterwards. It is carried out by experienced eye clinic The Type of Dye Used medical / nursing staff and a medical photographer. Fluorescein – The risks involved: You are advised NOT to drive for the rest This dye is a deep orange colour. It has of the day after you have had this been in use for many years. It has been procedure and you may wish to bring a proved safe to use in all patients. pair of sunglasses with you to protect Like all medicines, fluorescein dye can cause your eyes from bright lights / sunlight side effects but these are few in number. afterwards. The common side effects include nausea Indocyanine Green Angiography and vomiting. Skin rashes and itching are seen at times. This is a diagnostic procedure, when a dye is injected into a vein in your arm or hand and More serious side effects are spasm of the sets of digital photographs are taken to airway, anaphylactic shock and collapse. display blood vessels at the back of your However, these risks are extremely rare. eye. Sometimes this is combined with (see After injection, the skin shows a temporary Fundus Fluorescein Angiography above). yellow discolouration. During this stage, you should avoid exposure to direct sunlight.

Information for patients and visitors

Washing your skin will not remove the After injection, the skin can show a temporary discolouration. temporary discolouration (Yellow if combined If the dye leaks outside the vein it may cause with Fundus Fluorescein Angiography) temporary pain. This can be relieved by cold During this stage, you should avoid exposure compression. If the injection site remains to direct sunlight. Washing your skin will not painful or causes you concern, please seek remove the temporary discolouration. medical advice. If the dye leaks outside the vein it may cause The dye is metabolised in the liver and temporary pain. This can be relieved by cold excreted from your body via your kidneys. compression. If the injection site remains The urine remains orange-green in colour for painful or causes you concern, please seek 24 – 48 hours. medical advice. Indocyanine Green – The risks involved The dye is metabolised in the liver and The dye is a dark green powder which is excreted from your body via your kidneys. mixed with a suitable liquid to form a dark The urine remains orange-green in colour for green dye. It has been used in infants as 24 – 48 hours. well as adults patients for monitoring blood flow in the heart, liver and brain, as well as Patients with Diabetes deeper layers at the back of the eye Fluorescein dye gives a false high reading in (). the urine and on blood sugar tests. You Like all medicines, Indocyanine Green dye should not adjust your insulin or any of your can cause side effects although not diabetic treatments based on these results everybody gets them. during the first 2 days following the fluorescein angiogram. If you are concerned, The common side effects include nausea, please seek medical advice. feeling of warmth and flushing. Skin rashes (nettle rash) blotchy, itchy skin is seen at What will happen on the day of the times. procedure? Severe allergic reactions can include: On arrival for your appointment you will have  Tightness in the throat your vision tested and have dilating drops put into your eyes to enlarge the pupils.  Facial swelling This is to ensure the best photographs  A faster heart rate (palpitations) possible. It is important to take photographs  Tightness or pain in the chest of both eyes even if you only have a problem with one. You will have your blood pressure  A fall in blood pressure and checked and be asked about any allergies, breathlessness medications and medical conditions. You will  Collapse (cardiac arrest) then have a short wait whilst the eyedrops take effect (about 30 minutes), you will then Severe allergic reactions are very rare and be escorted to the photography room. affect fewer than 1 in 10,000 patients

Information for patients and visitors

Photographic methods Advice after your procedure You are seated in front of the camera with You are advised to eat and drink as normal your chin and forehead resting firmly on the and to take any GP / hospital prescribed frame. It may be necessary for the nurse to medications as normal unless you are told keep your head in position. otherwise by the medical / nursing staff. If you develop any problems over the next 24 The test is carried out in stages hours, please contact the eye clinic where A series of colour photographs are taken of you had your photography. the back of your eyes. Clinic hours: A tourniquet will be placed around your arm or wrist and your skin prepared for the Diana, Princess of Wales Hospital: procedure. A small tube (called a cannula) is inserted into a vein in your arm or hand and Monday – Friday between 8.30am – 5pm: secured with a dressing. Saline will be Phone Grimsby 01472 874111 ext 1155 injected through the cannula to check it is placed correctly in the vein. Scunthorpe General Hospital: The room lights will be turned off and dye(s) Monday – Friday between 8.30am – 5pm: injected. Once the dye reaches the back of Phone Scunthorpe 01724 282282 ext 2427 the eye, (this only takes a few seconds), the Goole and District Hospital: photographer will begin to take lots of pictures. Monday – Friday between 08.30 - 5pm: Phone Goole 01724 290074 The lights from the camera flash are quite bright but it is very important to keep your Evenings and weekends eye open, a nurse will help you if necessary. Phone Goole 01724 290030 You will then have a short rest. At other times please contact your own Another series of photographs will then be GP or the GP unit on: taken a few minutes later. The cannula will then be removed and you will be asked to Grimsby 01472 875575 wait in the waiting area for about 15 minutes. Scunthorpe 01724 290444 You will usually be given an appointment to discuss the results and plan your treatment with the eye doctor, although this sometimes possible on the same day as the test. If you have not received an appointment within 7 days please contact the eye clinic where you had your photography for advice and help.

Information for patients and visitors

Concerns and Queries The Trust and its staff are committed to providing high quality care to patients within If you have any concerns / queries about any the department. However, we wish to advise of the services offered by the Trust, in the all patients / visitors that the following first instance, please speak to the person inappropriate behaviour will not be tolerated: providing your care.  Swearing For Diana, Princess of Wales Hospital  Threatening / abusive behaviour Alternatively you can contact the Patient Advice and Liaison Service (PALS) on  Verbal / physical abuse (01472) 875403 or at the PALS office which The Trust reserves the right to withdraw from is situated near the main entrance. treating patients whom are threatening / For Scunthorpe General Hospital abusive / violent and ensuring the removal of Alternatively you can contact the Patient those persons from the premises. Advice and Liaison Service (PALS) on All acts of criminal violence and aggression (01724) 290132 or at the PALS office which will be notified to the Police immediately. situated on C Floor. Alternatively you can email: Risk Management Strategy [email protected] The Trust welcomes comments and suggestions from patients and visitors that Confidentiality could help to reduce risk. Information on NHS patients is collected in a Perhaps you have experienced something variety of ways and for a variety of reasons whilst in hospital, whilst attending as an (e.g. providing care and treatment, managing outpatient or as a visitor and you felt at risk. and planning the NHS, training and Please tell a member of staff on the ward or educating staff, research etc). in the department you are attending / visiting. Everyone working for the NHS has a legal duty to keep information about you Moving & Handling confidential. Information will only ever be The Trust operates a Minimal Lifting Policy, shared with people who have a genuine which in essence means patients are only need for it (e.g. your GP or other ever lifted by nursing staff in an emergency professionals from whom you have been situation. receiving care) or if the law requires it, for example, to notify a birth. Patients are always encouraged to help themselves as much as possible when Please be assured however that anyone who mobilising, and if unable to do so, equipment receives information from us is also under a may be used to assist in their safe transfer. legal duty to keep it confidential. If you have any questions regarding moving Zero Tolerance - Violent, and handling of patients within the Trust, Threatening and Abusive Behaviour please speak to a member of staff in the ward or department you are visiting.

Information for patients and visitors

Northern Lincolnshire and Goole NHS Foundation Trust Diana Princess of Wales Hospital Scartho Road Grimsby 01472 874111 Scunthorpe General Hospital Cliff Gardens Scunthorpe 01724 282282 Goole & District Hospital Woodland Avenue Goole 01405 720720 www.nlg.nhs.uk

Date of issue: September, 2015 Review Period: September, 2018 Author: Clinical Nurse Specialist () IFP-065 v3.0

© NLGFT 2015