Safety outcomes of half-dose fluorescein and indocyanine green angiography: a clinical assessment of adverse events.

Abstract

Purpose: To evaluate whether half‑dose administration of fluorescein and indocyanine green is associated with the incidence of adverse events during fluorescein angiography (FA) and indocyanine green angiography (ICGA).

Study design: Retrospective cohort study.

Methods: We analyzed 10,435 angiographic examinations in 10,435 unique patients performed using standard doses (fluorescein, 5 mL [500 mg]; indocyanine green, 2 mL [25 mg]) between April 2015 and March 2023, and half doses (fluorescein, 2.5 mL [250 mg]; indocyanine green, 1 mL [12.5 mg]) between April 2023 and March 2024. Explanatory variables included dye dose (half vs. standard), age, sex, diabetes, hypertension, asthma, history of drug allergy, vital signs at examination (systolic/diastolic blood pressure, pulse rate), and meteorological factors (temperature, atmospheric pressure). After univariable analyses, multivariable logistic regression was performed. P < 0.05 was considered statistically significant.

Results: Adverse events assessed in the main analyses included rash, nausea/vomiting during FA, ICGA, or combined FA+ICGA, and hypotension. The overall incidence of adverse events was significantly lower in the half‑dose group (6.21%) than in the standard‑dose group (10.65%; P < 0.001). Half-dose administration was associated with lower odds of rash (odds ratio [OR] = 0.46; P = 0.001), nausea/vomiting during FA (OR = 0.24; P < 0.001), and nausea/vomiting during combined FA+ICGA (OR = 0.58; P = 0.002). Younger age was an independent risk factor for several adverse events.

Conclusions: Half‑dose dye administration was associated with lower incidences of rash and nausea/vomiting. Dose reduction may contribute to improved safety in FA and ICGA.