IT IS APPLIED AS A 1 OR 2% SOLUTION AS EYE DROPS OR AS STERILE PAPERS IMPREGNATED WITH FLUORESCEIN SODIUM. IT MAY ALSO BE GIVEN WITH A LOCAL ANAESTHETIC, TYPICALLY AS A 0.25% SOLUTION WITH LIDOCAINE HYDROCHLORIDE, OXYBUPROCAINE HYDROCHLORIDE, OR PROXYMETACAINE HYDROCHLORIDE.
FLUORESCEIN SODIUM MAY BE GIVEN BY RAPID INTRAVENOUS INJECTION, USUALLY AS A SOLUTION EQUIVALENT TO FLUORESCEIN 10 OR 25%, FOR RETINAL ANGIOGRAPHY. THE USUAL DOSE IS THE EQUIVALENT OF 500 MG OF FLUORESCEIN. A DOSE OF 7.5 MG/KG HAS BEEN SUGGESTED FOR CHILDREN. THE ORAL ROUTE HAS ALSO BEEN TRIED FOR ANGIOGRAPHY. OTHER USES OF INTRAVENOUS FLUORESCEIN SODIUM HAVE INCLUDED THE DIFFERENTIATION OF HEALTHY FROM DISEASED OR DAMAGED TISSUE AND VISUALISATION OF THE BILIARY TRACT.
FLUORESCEIN DILAURATE IS GIVEN BY MOUTH FOR THE ASSESSMENT OF EXOCRINE PANCREATIC FUNCTION . PANCREATIC ENZYMES HYDROLYSE THE ESTER AND THE AMOUNT OF FREE FLUORESCEIN EXCRETED IN THE URINE CAN THEREFORE BE TAKEN AS A MEASURE OF PANCREATIC ACTIVITY. A DOSE OF 348.5 MG OF FLUORESCEIN DILAURATE, EQUIVALENT TO 0.5 MMOL OF FLUORESCEIN, IS GIVEN WITH A STANDARD MEAL, AND URINE COLLECTED FOR THE NEXT 10 HOURS. THE MANUFACTURERS GIVE INSTRUCTIONS CONCERNING THE TYPE AND AMOUNT OF LIQUID AND FOOD WHICH MAY BE TAKEN DURING THIS PERIOD. A CONTROL DOSE OF 188.14 MG OF FLUORESCEIN SODIUM, ALSO EQUIVALENT TO 0.5 MMOL OF FLUORESCEIN, IS GIVEN ON THE NEXT DAY UNDER THE SAME CONDITIONS.
STUDIES OF THE FLUORESCEIN DILAURATE TEST HAVE CONSIDERED IT TO BE A USEFUL NONINVASIVE SCREENING TEST FOR THE EXCLUSION OF PANCREATIC EXOCRINE FAILURE IN OUTPATIENTS, PARTICULARLY THOSE PRESENTING WITH STEATORRHOEA. THE NEED FOR TESTS SUCH AS THE PANCREOZYMIN-SECRETIN TEST, WHICH REQUIRES DUODENAL INTUBATION, MAY THUS BE AVOIDED. HOWEVER, LOW SPECIFICITY (A RELATIVELY HIGH RATE OF FALSE-POSITIVE RESPONSES) HAS BEEN REPORTED WITH THE FLUORESCEIN DILAURATE TEST IN SOME PATIENT POPULATIONS, AND THE NEED FOR CAREFUL PATIENT INSTRUCTION IN PERFORMANCE OF THE TEST HAS BEEN EMPHASISED. IN ORDER TO AVOID THE PROLONGED COLLECTION OF URINE NECESSARY IN THE STANDARD TEST, SERUM CONCENTRATIONS OF FLUORESCEIN MAY BE MEASURED SEVERAL HOURS AFTER TAKING THE TEST SUBSTANCE.
THE TEST HAS BEEN USED SUCCESSFULLY IN CHILDREN, PARTICULARLY WHEN THE DOSES OF FLUORESCEIN DILAURATE AND FLUORESCEIN SODIUM ARE REDUCED AND FLUID INTAKE MODIFIED, ALTHOUGH THE MANUFACTURERS RECOMMEND THAT THE COMMERCIALLY AVAILABLE TEST IS NOT USED FOR THIS AGE GROUP. IN CHILDREN, A SIMPLIFIED, SINGLE-DAY TEST USING DUAL MARKERS, FLUORESCEIN DILAURATE AND MANNITOL, HAS BEEN INVESTIGATED WITH ENCOURAGING RESULTS. THE FLUORESCEIN DILAURATE TEST WAS FOUND TO BE MORE SENSITIVE THAN THE FAECAL ELASTASE 1 TEST FOR THE DIAGNOSIS OF MILD-TO-MODERATE EXOCRINE PANCREATIC INSUFFICIENCY IN A STUDY INVOLVING 40 PATIENTS.
INFESTATION OF THE EYE LASHES OR BROWS WITH PUBIC LICE HAS BEEN SUCCESSFULLY TREATED WITH A SINGLE APPLICATION OF A 20% SOLUTION OF FLUORESCEIN.
FLUORESCEIN IS USUALLY GIVEN INTRAVENOUSLY FOR RETINAL ANGIOGRAPHY, BUT A STUDY IN 20 HEALTHY SUBJECTS CONCLUDED THAT AN ORAL DOSE OF FLUORESCEIN SODIUM 25 MG/KG COULD PRODUCE GOOD QUALITY RETINAL ANGIOGRAMS IN THE MAJORITY OF SUBJECTS. THIS STUDY USED SPECIALLY PREPARED 500-MG CAPSULES OF FLUORESCEIN SODIUM; THE AUTHORS COMMENTED THAT PREVIOUS ORAL STUDIES HAD USED THE LIQUID PREPARATION INTENDED FOR INTRAVENOUS USE. ONLY MILD REACTIONS, POSSIBLY DUE TO HYPERSENSITIVITY, APPEAR TO HAVE BEEN REPORTED WITH ORAL FLUORESCEIN.