Fundamentals of Fluorescein Angiography
The Role of the Angiographer

Timothy J. Bennett, CRA FOPS
Department of Ophthalmology
Penn State University
Hershey, Pennsylvania

Some ophthalmologists perform their own angiography, but this is an exception rather than the rule. Most facilities employ a photographer or technician dedicated to performing ophthalmic photography procedures. Unfortunately, there is little available education in fluorescein angiography. In the absence of formal education, certification plays a very important role in developing competent practitioners in angiography. The Ophthalmic Photographers Society offers a voluntary certification program in fluorescein angiography. The Certified Retinal Angiographer (CRA) program was established in 1979 and to date, nearly 800 individuals have successfully achieved recognition as a CRA. This credential is recognized in the ophthalmic community as an objective measure of competence in fundus photography and fluorescein angiography, and is meant to assure employers and the public that an individual has demonstrated a high level of proficiency in the field. The CRA Program is accredited by the by the National Commission for Certifying Agencies. Accreditation of the CRA program reinforces the value of the credential, and the respect associated with those who hold it. Anyone performing fluorescein angiography is strongly encouraged to pursue certification as a CRA.

The responsibility for injecting fluorescein dye sometimes falls to the angiographer or a technician. From a logistical standpoint, it may be advantageous for angiographers to do injections themselves, as long as they are qualified and legally authorized to do so. Angiographers performing intravenous injections should have documented training in venipuncture, IV administration of dyes, and universal precautions. It is highly recommended that angiographers check their current state or local laws regarding the credentialing requirements of personnel performing intravenous injections as there can be legal issues associated with unlicensed personnel performing fluorescein injections in some states.(9-10)