Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?△

Abstract

Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography (FFA) remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy(CIN) and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

Metformin induced acute kidney injury; a systematic review

“…In addition, a single center observational study demonstrated that metformin therapy prior to elective CAG is safer in patients with preserved left ventricular ejection fraction of >40% or even with mild renal dysfunction (19). Likewise, in diabetic patients receiving metformin, no CIN has been reported after fundus fluorescein angiography (FFA) using fluorescein sodium (20).…”