Hold up of dye in the arm during fluorescein angiography: A quantitative demonstration

PURPOSE: To demonstrate a hold-up of part of the fluorescein bolus in the a rm as a result of arm position. METHOD: Case report. We obtained a fluorescein angiogram with a calibrated confocal scanning laser ophthalmoscope in a 20-year-old healthy subject. Du ring and after injection, the upper arm was held in approximately 60 degree s abduction, 65 degrees exorotation, and slight anteflexion. In the late ve nous phase, the subject moved the upper arm on the injected side to a more neutral, downward position, RESULTS: We measured a distinct rise in fluorescence level about 10 seconds after movement of the arm, The most likely explanation is relief of a part ial obstruction of the venous drainage, which had been caused by the positi on of the upper arm described above. CONCLUSION: Impaired venous drainage of the injected arm caused by exorotat ion and abduction of the upper arm is a potentially common cause of delayed dye arrival or unexpectedly reduced contrast level during fluorescein angi ography, Therefore, arm position needs attention in fluorescein angiography .(Am J Ophthalmol 2000;129: 551-552, (C) 2000 by Elsevier Science Inc. All rights reserved).