HYPERSENSITIVITY TO SODIUM FLUORESCEIN

Abstract
Sodium fluorescein is a dibasic xanthin used in ophthalmology. It is used topically in tonometries, in the diagnosis of coriorretinianal injuries and orally or intravenously as contrast material in retinal angiographies. Diverse adverse reactions in all its routes of administration have been reported. According to their intensity and the need of medical intervention they are classified as slight, moderate and severe. The etiology of these reactions is unknown. To update the incidence of adverse reactions produced by the intravenous use and the possibility to prevent these reactions using cutaneous tests, a review of publications on this issue has been performed. Several publications described patients who underwent an anaphylactic shock whose cutaneous tests (prick test with sodium fluorescein) had been positive; and in other series of patients prick test prior to the retinofluoresceinography predicted the occurrence of the shock. Specific IgE could not be demonstrated in any of the cases, but the occurrence of the reactions was more frequent in those who had undergone one or more retinofluoresceinographies. Conclusions: prick test with sodium fluorescein at 10% is useful to prevent the adverse reactions produced by its intravenous use and discards the false positives of the intradermal skin test.

Key words
Sodium fluorescein, adverse reactions, prick tests, anaphylactic shock, retinofluoresceinography

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