Macular Degeneration

Best Test for Macular Degeneration

What’s the best test to diagnose macular degeneration? A fluorescein angiogram can distinguish normal drusen from ARMD.

When You Need Eye Exam for Macular Degeneration. Randall Wong, M.D., Retina specialist, Fairfax, Virginia.The best test for macular degeneration (ARMD) is a fluorescein angiogram (FA).  The fluorescein angiogram involves the injection of a dye (not iodine based) called fluorescein.  As the fluorescein dye travels through your retina, pictures are taken which may help your doctor diagnose macular degeneration.

Who Performs a Fluorescein Angiogram?

In most instances, a retinal specialist performs an FA.  It is a diagnostic test used mainly for the diagnosis and treatment of retinal diseases.

In addition to macular degeneration, an angiogram may be helpful in cases of retinal vein or retinal artery occlusions, diabetic retinopathy, macular edema, etc.  In cases of macular degeneration, a fluorescein angiogram is integral in distinguishing wet ARMD from dry ARMD.

When to Perform a Fluorescein Angiogram

With respect to macular degeneration, the test should be performed at baseline and then if there there are any changes in vision.  For instance, if a patient has a loss or change in vision including new distortion.

Many patients receive anti-VEGF injections of Avastin, Lucentis or Eylea for control of the wet ARMD.  A fluorescein angiogram is very useful in monitoring treatment for wet ARMD.

Patients with drusen or a questionable case of ARMD should obtain a fluorescein angiogram.  This will help differentiate those patients with “normal” drusen versus patients with early macular disease.

What Does This Mean?

A fluorescein angiogram is integral to the diagnosis macular degeneration.  It is the single best test to make a new diagnosis and to also monitor treatment.

The test is fairly easy to obtain…from a retinal specialist.  In my practice, this test invaluable for the diagnosis and management of ARMD.  It is especially helpful for patients in whom the diagnosis is suspect, or, in patients given the diagnosis, but have perfectly normal vision.



By Randall Wong, M.D.

As a retina specialist, I've been very successful with my websites to educate my patients about what I do professionally.

I am a father of five, have a passion for SEO, love Dunkin' Donuts and don't care for Starbucks coffee, love tennis, but only like to watch golf. I'm a huge youth ice hockey supporter and love Labrador retrievers.

10 replies on “Best Test for Macular Degeneration”


If you saw a person who presented with dry Mac. Degen, would you do ANY treatments, like shots, to prevent it from going wet? Could shots cause dry to become wet, aggravating this condition or creating inflammation? When you do treat a patient for MD, how many shots would you continue to do for wet MD that was showing no benefit at all? Also, once an eye has gone from wet, back to dry, can it become wet again?

Hi Dr.Wong,
I have been getting information from you for a few years and I would like to thank you. I am once again experiencing wavy lines and blurry vision in my left eye due to histoplasmosis . I had one treatment of pdt 4 yrs ago and it helped. Had another this week and no improvement. People just don’t understand this disease in this area of the country. ( upstate New York) do you have any recommendations for the best eye clinics in the country that deal with this regularly? Thank you, Patty

Hello Dr. I’m impressed that you created this site to help and inform people, very kind of you!

I have a condition in my left eye, everything is blurry like looking through a glass. My eye Dr did an eye exam and advised me to see a Retina Dr. So I did and after lots of drops, pictures, and inspection of my eyes, The Dr said this. I have pigment epithelial detachment encroaching on the fovea inferonasally and i also have numerous legions around the pole in both eyes. He wants me to start a anti-VEGF therapy. I’m a 52yr old male, and nervous about what is wrong with me. The Dr seemed like he never saw my condition before or what to call it! Can you explain or recommend what my next step is?

Thanks again for being you! Joseph

Joseph W.,

Pigment epithelial detachments are not uncommon, but the question is…will Avastin work? Sometimes it does and sometimes it does not, my guess that’s what you noticed in his behavior.


Thanks Dr Wong, I’ve since had 3 shots of Avastin, and what they see is 1st treatment showed reducing of leakage, the 2nd the area got larger, now this is my 3rd and I don’t see an improvement, He mentioned he might use a different drug which i forgot the name of. sorry. But he says there’s nothing else that can be done except to try and keep it from getting worse. Is that true? he said it was brain tissue were talking about, Can you please explain why it can’t be fixed? I’m sorry for bothering you, but I believe you are the best in this field and value your knowledge.

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