I note several things that jump out at me.   5ML of 10%  was the amount being used.  Would be interesting to see if VOLUME of fluid being injected slow vs fast was an issue.  Anyone in the USA actually still using 5ml of 10%?  Didn't that go out of favor in the 80's?  Particularly with these very sensitive SLO systems, we can easily get by without the full 3ml of 25%, and cut it down to half that with very good results ( albeit, always, in the properly selected patient...)

Also, might not the manufacturer and/or the PH value of the sodium fluorescein be an issue here?  Seems to me that this report provokes more questions in me than resolution of issue.

Denice Barsness

I've been using 5ml of 10% for the last 24 years. It's still pretty commonly used. I agree this raises more questions. I've tracked reactions since 1988 & my experience is the exact opposite of the study. The difference could be patient population, brand of dye, concentration, injection technique, caliber of vein, blood pressure, room temperature.

This is the second report that suggests that faster injections (one out of Wilmer many years ago) results in less nausea. My guess is that many of us have anecdotal experience that conflicts with the published reports.

I've often thought this is the sort of project that the OPS could take on to put to rest. We have strength in numbers & could conduct a study that many of our members participate in.
We could look at more of the variables (demographics, brand, concentration, total dose) that aren't covered by the previous reports.

Adding to the ophthalmic literature in this way would be good for the OPS & our members. WIsh I had more time on my hands...

We have used a variety of brands from a variety of vendors with similar results/reactions to all. Although we still get the occasional nausea/vomiting I think the frequency has decreased over the past years. I have no hard data to back this up, just an observational impression from the imager's chair.

Agree that we, the OPS, would be the perfect group to conduct a study to truly look into adminstration, side effects and reactions to fluorescein. Let's get a discussion going amongst the BOD about this.

BTW - we have found faster is better than slower for reduced nausea. The difficulty is convincing the MD's whos do the injections. And their presception of "faster". Some of them think faster is 15-20 seconds.

bob 

This is the second report that suggests that faster injections (one out of Wilmer many years ago) results in less nausea. 

I've attached another report that indicates that faster injections result in less adverse reactions.  This one is from Sweeden.  

-  Sarah