Du Junhui, Li Rong
Department of Ophthalmology, Xi'an Ninth Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shanxi 710054, China.
Department of Ophthalmology, The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shanxi 710077, China.
Chin Med Sci J. 2017 Jun 10;32(2):119-2. doi: 10.24920/J1001-9294.2017.015.
Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography (FFA) remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy(CIN) and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.
二甲双胍是一种已广泛应用于糖尿病患者的双胍类降糖药。在临床实践中，眼底荧光血管造影（FFA）前是否应停用二甲双胍在很大程度上仍不明确。一些内分泌学家建议在FFA前停用二甲双胍。然而，眼科医生在实际操作中并不总是采纳这一观点。这种情况可能导致医患纠纷。本文分析了对比剂肾病（CIN）及相关造影剂，以及荧光血管造影的不良反应。指出这种差异可能是由于对FFA中使用的造影剂存在误解所致。对于使用碘造影剂的血管造影，由于CIN可能性增加，必须停用二甲双胍，而对于使用荧光素钠的FFA，尚未有CIN的报道。因此，作者认为FFA对口服二甲双胍的糖尿病患者是安全的，检查前无需停用二甲双胍。
