Best Test for Macular Degeneration

Best Test for Macular Degeneration

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.



  • maged
    Posted at 11:53h, 26 March Reply

    dear dr,

    is it necessary to do 380 laser for the retina before vitrectomy


  • Jan
    Posted at 15:45h, 09 April Reply


    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?

    • Randall V. Wong, M.D.
      Posted at 09:34h, 20 April Reply


      Shots do not cause dry ARMD to become wet ARMD. I personally like to try 3 shots before determining if effective. Yes, wet recur and often does.

      I hope this was helpful.


  • Patricia
    Posted at 07:28h, 17 May Reply

    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

    • Randall V. Wong, M.D.
      Posted at 10:23h, 21 May Reply


      There used to be a of interest about histoplasmosis at the Washington University. I have a patient who I’ll ask to email you or reply here.


  • Joseph W.
    Posted at 22:44h, 22 May Reply

    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

    • Randall V. Wong, M.D.
      Posted at 23:15h, 09 June Reply

      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.


  • Joseph Walsh
    Posted at 19:03h, 16 September Reply

    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.

    • Randall V. Wong, M.D.
      Posted at 22:21h, 21 September Reply


      What is your diagnosis? There are several reasons why we use Avastin.

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