First of all, I apologize if this is not the correct subreddit to post this. I'm just curious to know your thoughts on this topic as my colleagues and I, can't seem to agree.
For context, I'm a primary care physician and the following information is from a colleague's patient.
Male 72yo. PMHx of FA, CKD 3a (cr 1.8, eGFR = 37.78), hyperurecemia. Also, macular degeneration, oftalmologist suggests fluorescein angiography despite renal function.
Opftalmologist argues that he has done this procedure many times to other patients with CKD with no complications. On the other hand, internist suggests an alternative image (optical coherence tomography -OCT), as doing an angiography with the current creatine clearance of the patient, could lead to nephrosclerosis. Additionally, the internist argues that although the patient's eGFR is not in the range to be considered a contraindication for an angiography (<30ml/min) it is too close to it. She recommends an OCT if possible and as a last resort the fluorescein angiography if there is no other choice.
My colleagues and I were puzzled about this so we went ahead to revise the literature on topic but we couldn't find a lot of information on it. There are a few studies out there but they were a bit contradictory and we weren't able to agree.
What are your thoughts on it? Would you have ordered the fluorescein angiography for this patient? if there is any literature on this topic that you would like to suggest or share with us, that would be greatly appreciated.
Source: Original link