Skin testing and adverse reactions in fluorescein: A prospective study

Kalogeromitros, D.; Makris, Michael; Rouvas, Alexandros; Theodossiadis, Panagiotis; Spanoudaki, Nektaria; Papaioannou, Dimitrios

doi:10.2500/aap.2007.28.3024

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…In conclusion, this study expands in a larger patient population our previous finding that allergy skin testing cannot predict ARs to SFAs (Kalogeromitros et al. 2007).…”

Section: Discussionsupporting

confidence: 55%

Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study

Kalogeromitros

Makris

Aggelides

et al. 2009

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate allergy skin testing as a diagnostic tool of adverse reactions to fluorescein and whether allergy and previous sodium fluorescein angiography (SFA) act as predisposing factors. Methods: Patients with adequate indication for fluorescein angiography and normal skin responsiveness were subjected to allergy skin-prick and intradermal tests for fluorescein, followed by SFA. During SFA, adverse reactions were monitored and classified as mild, moderate or severe. Previous SFAs and adverse reactions as well as the presence of atopy were also registered. Results: One thousand and thirty-seven patients were enrolled in the study and 1284 SFAs were executed. Forty-four patients (4.3%) developed 55 adverse reactions; among them 50 (3.8%) were mild, three (0.2%) moderate and two (0.16%) severe. None of the reactors produced positive skin tests to fluorescein. Patients with atopy and previous SFAs were not more susceptible to adverse reactions. Conclusion: The vast majority of adverse reactions to fluorescein are mild and not attributed to immunological mechanisms. Allergy skin tests cannot predict non-immunological reactions but their utility remains substantial in predicting anaphylaxis during SFAs and must be performed in patients reporting risk factors in their past medical history.

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“…In conclusion, this study expands in a larger patient population our previous finding that allergy skin testing cannot predict ARs to SFAs (Kalogeromitros et al. 2007).…”

Section: Discussionsupporting

confidence: 55%

Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study

Kalogeromitros

Makris

Aggelides

et al. 2009

Acta Ophthalmologica

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“…29,30 Some have suggested requiring intradermal skin testing to determine hypersensitivity to fluorescein prior to use if an allergy is suspected, but skin testing has failed to reliably identify reactors in prospective studies. 31 While severe adverse reactions to fluorescein may be rare, there is a lack of literature outlining the upper tolerable levels of fluorescein. This prohibits its safe use as a tracer in human trials to study aerosol and droplet dispersion.…”

Section: Discussionmentioning

confidence: 99%

Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology

Sim

Dharmarajan

Boorgu

et al. 2020

Ann Otol Rhinol Laryngol

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Objective: During the COVID-19 era, a reliable method for tracing aerosols and droplets generated during otolaryngology procedures is needed to accurately assess contamination risk and to develop mitigation measures. Prior studies have not investigated the reliability of different fluorescent tracers for the purpose of studying aerosols and small droplets. Objectives include (1) comparing vitamin B2, fluorescein, and a commercial fluorescent green dye in terms of particle dispersion pattern, suspension into aerosols and small droplets, and fluorescence in aerosolized form and (2) determining the utility of vitamin B2 as a fluorescent tracer coating the aerodigestive tract mucosa in otolaryngology contamination models. Methods: Vitamin B2, fluorescein, and a commercial fluorescent dye were aerosolized using a nebulizer and passed through the nasal cavity from the trachea in a retrograde-intubated cadaveric head. In another scenario, vitamin B2 was irrigated to coat the nasal cavity and nasopharyngeal mucosa of a cadaveric head for assessment of aerosol and droplet generation from endonasal drilling. A cascade impactor was used to collect aerosols and small droplets ≤14.1 µm based on average aerodynamic diameter, and the collection chambers were visualized under UV light. Results: When vitamin B2 was nebulized, aerosols ≤5.4 µm were generated and the collected particles were fluorescent. When fluorescein and the commercial water tracer dye were nebulized, aerosols ≤8.61 µm and ≤2.08 µm respectively were generated, but the collected aerosols did not appear visibly fluorescent. Endonasal drilling in the nasopharynx coated with vitamin B2 irrigation yielded aerosols ≤3.30 µm that were fluorescent under UV light. Conclusion: Vitamin B2’s reliability as a fluorescent tracer when suspended in aerosols and small droplets ≤14.1 µm and known mucosal safety profile make it an ideal compound compared to fluorescein and commercial water-based fluorescent dyes for use as a safe fluorescent tracer in healthcare contamination models especially with human subjects.

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Sensitivity and specificity of optical coherence tomography angiography in the diagnosis of active choroidal neovascularization: a systematic review and meta-analysis

Wang

Gao

Zhang

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Skin testing and adverse reactions in fluorescein: A prospective study

Cited by 5 publications

References 13 publications

Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study

Allergy skin testing in predicting adverse reactions to fluorescein: a prospective clinical study

Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology

Sensitivity and specificity of optical coherence tomography angiography in the diagnosis of active choroidal neovascularization: a systematic review and meta-analysis

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