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The Fundus Autofluorescence Spectrum of Punctate Inner Choroidopathy.

Li M, Zhang X, Wen F - J Ophthalmol (2015)

Bottom Line: Third, hypoautofluorescent spots of PIC lesions coexisted with hyperautofluorescent patches on SW-FAF imaging.Conclusion.FAF imaging helps in noninvasively tracking the evolution of PIC lesions and identifying the combined MEWDS or AZOOR lesions, complementary to SD-OCT and angiographic studies.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.

ABSTRACT
Purpose. To investigate the fundus autofluorescence (FAF) spectrum of punctate inner choroidopathy (PIC). Methods. This is a retrospective observational case series of 27 consecutive patients with PIC admitted from October 2013 to March 2015, who underwent short-wavelength- (SW-) and near-infrared- (NIR-) FAF imaging, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA). Results. There were three primary findings on the FAF imaging of patients with PIC. First, active PIC lesions revealed hypoautofluorescent spots with hyperautofluorescent margin. After the lesions regressed, the hyperautoflurescent margin faded. Second, subclinical and most of the atrophic PIC lesions appeared to be hypoautofluorescent spots. But subclinical PIC lesions were more distinctive on NIR-FAF imaging than on SW-FAF imaging. Third, hypoautofluorescent spots of PIC lesions coexisted with hyperautofluorescent patches on SW-FAF imaging. These hyperautofluorescent patches were demonstrated to be multiple evanescent white dot syndrome (MEWDS) or acute zonal occult outer retinopathy (AZOOR) lesions by subsequent multimodal imaging and faded during follow-up examinations. Conclusion. FAF imaging helps in noninvasively tracking the evolution of PIC lesions and identifying the combined MEWDS or AZOOR lesions, complementary to SD-OCT and angiographic studies.

No MeSH data available.


Related in: MedlinePlus

Fundus photography (a, f), SW-FAF (b, g), FA (c, h), ICGA (d, i), and SD-OCT (e, j) of the right eye of a 24-year-old female at the initial visit and 5 weeks later. At the initial visit, her BCVA was 0.2. (a) There were scattered yellowish spots in the upper posterior pole in addition to the yellow-gray PIC lesions. (b) Diffuse hyperautofluorescent areas were shown on SW-FAF, which tended to emerge in the macula and around the optic disc. Additionally, the hypoautofluorescent PIC lesions were surrounded by hyperautofluorescent edge. (c) FA revealed patches of hyperfluorescence, which was especially obvious in late phase and the extent was smaller than it was on SW-FAF and ICGA.The PIC lesions showed hyperfluorescent spots with slight leakage. (d) Hypocyanescent spots were indicated in the late phase of ICGA. (e) The red line (crossing a PIC lesion and hyperautofluorescent areas on SW-FAF) shown on SD-OCT was dome-shaped high reflective materials (arrow), with underlying disrupted EZ. Additionally, an active lesion (stage III) was detected. Five weeks later, the MEWDS lesions faded completely on fundus photography (f), SW-FAF (g), FA (h), and ICGA (i). Meanwhile, the dome-shaped high reflective materials on SDOCT disappeared and disruption of EZ near-completely recovered (j). The hyperautofluorescent margin of the PIC lesion faded on SW-FAF (g). The PIC lesion regressed on SD-OCT (j). Her BCVA was improved to 0.32.
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fig3: Fundus photography (a, f), SW-FAF (b, g), FA (c, h), ICGA (d, i), and SD-OCT (e, j) of the right eye of a 24-year-old female at the initial visit and 5 weeks later. At the initial visit, her BCVA was 0.2. (a) There were scattered yellowish spots in the upper posterior pole in addition to the yellow-gray PIC lesions. (b) Diffuse hyperautofluorescent areas were shown on SW-FAF, which tended to emerge in the macula and around the optic disc. Additionally, the hypoautofluorescent PIC lesions were surrounded by hyperautofluorescent edge. (c) FA revealed patches of hyperfluorescence, which was especially obvious in late phase and the extent was smaller than it was on SW-FAF and ICGA.The PIC lesions showed hyperfluorescent spots with slight leakage. (d) Hypocyanescent spots were indicated in the late phase of ICGA. (e) The red line (crossing a PIC lesion and hyperautofluorescent areas on SW-FAF) shown on SD-OCT was dome-shaped high reflective materials (arrow), with underlying disrupted EZ. Additionally, an active lesion (stage III) was detected. Five weeks later, the MEWDS lesions faded completely on fundus photography (f), SW-FAF (g), FA (h), and ICGA (i). Meanwhile, the dome-shaped high reflective materials on SDOCT disappeared and disruption of EZ near-completely recovered (j). The hyperautofluorescent margin of the PIC lesion faded on SW-FAF (g). The PIC lesion regressed on SD-OCT (j). Her BCVA was improved to 0.32.

Mentions: It was detected by SW-AF imaging in 10 of the 27 patients with PIC, with one patient bilaterally affected. All of them had acute visual disturbance, although four were with atrophic PIC lesions. In nine of these patients, the hyperautofluorescent patches were demonstrated to be multiple evanescent white dot syndrome (MEWDS) lesions by multimodal imaging. On fundus examination, the diffuse hyperautofluorescent patches corresponded to scattered yellowish spots but were more numerous. The corresponding areas on SD-OCT manifested as discontinuous of the ellipsoid zone (EZ) with or without dome-shaped high reflective materials. On FA, the retina areas with hyperautofluorescent patches were identified as hyperfluorescence from the initial phase and stained or with slight leakage in the late phase. Using ICGA, they showed multiple hypocyanescent spots during the late phase and were more numerous than the lesions seen under funduscope or by FA. The hyperautofluorescent areas faded completely on follow-up SW-FAF imaging. Meanwhile, the corresponding disruption of EZ recovered and the dome-shaped high reflective materials disappeared on SD-OCT, and the correlated hypocyanescent spots on ICGA became normal (Figure 3). All the patients achieved visual acuity improvement.


The Fundus Autofluorescence Spectrum of Punctate Inner Choroidopathy.

Li M, Zhang X, Wen F - J Ophthalmol (2015)

Fundus photography (a, f), SW-FAF (b, g), FA (c, h), ICGA (d, i), and SD-OCT (e, j) of the right eye of a 24-year-old female at the initial visit and 5 weeks later. At the initial visit, her BCVA was 0.2. (a) There were scattered yellowish spots in the upper posterior pole in addition to the yellow-gray PIC lesions. (b) Diffuse hyperautofluorescent areas were shown on SW-FAF, which tended to emerge in the macula and around the optic disc. Additionally, the hypoautofluorescent PIC lesions were surrounded by hyperautofluorescent edge. (c) FA revealed patches of hyperfluorescence, which was especially obvious in late phase and the extent was smaller than it was on SW-FAF and ICGA.The PIC lesions showed hyperfluorescent spots with slight leakage. (d) Hypocyanescent spots were indicated in the late phase of ICGA. (e) The red line (crossing a PIC lesion and hyperautofluorescent areas on SW-FAF) shown on SD-OCT was dome-shaped high reflective materials (arrow), with underlying disrupted EZ. Additionally, an active lesion (stage III) was detected. Five weeks later, the MEWDS lesions faded completely on fundus photography (f), SW-FAF (g), FA (h), and ICGA (i). Meanwhile, the dome-shaped high reflective materials on SDOCT disappeared and disruption of EZ near-completely recovered (j). The hyperautofluorescent margin of the PIC lesion faded on SW-FAF (g). The PIC lesion regressed on SD-OCT (j). Her BCVA was improved to 0.32.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig3: Fundus photography (a, f), SW-FAF (b, g), FA (c, h), ICGA (d, i), and SD-OCT (e, j) of the right eye of a 24-year-old female at the initial visit and 5 weeks later. At the initial visit, her BCVA was 0.2. (a) There were scattered yellowish spots in the upper posterior pole in addition to the yellow-gray PIC lesions. (b) Diffuse hyperautofluorescent areas were shown on SW-FAF, which tended to emerge in the macula and around the optic disc. Additionally, the hypoautofluorescent PIC lesions were surrounded by hyperautofluorescent edge. (c) FA revealed patches of hyperfluorescence, which was especially obvious in late phase and the extent was smaller than it was on SW-FAF and ICGA.The PIC lesions showed hyperfluorescent spots with slight leakage. (d) Hypocyanescent spots were indicated in the late phase of ICGA. (e) The red line (crossing a PIC lesion and hyperautofluorescent areas on SW-FAF) shown on SD-OCT was dome-shaped high reflective materials (arrow), with underlying disrupted EZ. Additionally, an active lesion (stage III) was detected. Five weeks later, the MEWDS lesions faded completely on fundus photography (f), SW-FAF (g), FA (h), and ICGA (i). Meanwhile, the dome-shaped high reflective materials on SDOCT disappeared and disruption of EZ near-completely recovered (j). The hyperautofluorescent margin of the PIC lesion faded on SW-FAF (g). The PIC lesion regressed on SD-OCT (j). Her BCVA was improved to 0.32.
Mentions: It was detected by SW-AF imaging in 10 of the 27 patients with PIC, with one patient bilaterally affected. All of them had acute visual disturbance, although four were with atrophic PIC lesions. In nine of these patients, the hyperautofluorescent patches were demonstrated to be multiple evanescent white dot syndrome (MEWDS) lesions by multimodal imaging. On fundus examination, the diffuse hyperautofluorescent patches corresponded to scattered yellowish spots but were more numerous. The corresponding areas on SD-OCT manifested as discontinuous of the ellipsoid zone (EZ) with or without dome-shaped high reflective materials. On FA, the retina areas with hyperautofluorescent patches were identified as hyperfluorescence from the initial phase and stained or with slight leakage in the late phase. Using ICGA, they showed multiple hypocyanescent spots during the late phase and were more numerous than the lesions seen under funduscope or by FA. The hyperautofluorescent areas faded completely on follow-up SW-FAF imaging. Meanwhile, the corresponding disruption of EZ recovered and the dome-shaped high reflective materials disappeared on SD-OCT, and the correlated hypocyanescent spots on ICGA became normal (Figure 3). All the patients achieved visual acuity improvement.

Bottom Line: Third, hypoautofluorescent spots of PIC lesions coexisted with hyperautofluorescent patches on SW-FAF imaging.Conclusion.FAF imaging helps in noninvasively tracking the evolution of PIC lesions and identifying the combined MEWDS or AZOOR lesions, complementary to SD-OCT and angiographic studies.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.

ABSTRACT
Purpose. To investigate the fundus autofluorescence (FAF) spectrum of punctate inner choroidopathy (PIC). Methods. This is a retrospective observational case series of 27 consecutive patients with PIC admitted from October 2013 to March 2015, who underwent short-wavelength- (SW-) and near-infrared- (NIR-) FAF imaging, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA). Results. There were three primary findings on the FAF imaging of patients with PIC. First, active PIC lesions revealed hypoautofluorescent spots with hyperautofluorescent margin. After the lesions regressed, the hyperautoflurescent margin faded. Second, subclinical and most of the atrophic PIC lesions appeared to be hypoautofluorescent spots. But subclinical PIC lesions were more distinctive on NIR-FAF imaging than on SW-FAF imaging. Third, hypoautofluorescent spots of PIC lesions coexisted with hyperautofluorescent patches on SW-FAF imaging. These hyperautofluorescent patches were demonstrated to be multiple evanescent white dot syndrome (MEWDS) or acute zonal occult outer retinopathy (AZOOR) lesions by subsequent multimodal imaging and faded during follow-up examinations. Conclusion. FAF imaging helps in noninvasively tracking the evolution of PIC lesions and identifying the combined MEWDS or AZOOR lesions, complementary to SD-OCT and angiographic studies.

No MeSH data available.


Related in: MedlinePlus