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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, e), SW-FAF (b, f), ICGA (c), perimetry (d), and SD-OCT (g, h, i, and j) of the right eye of a 32-year-old female at the initial visit and 2 months later. The presented BCVA was 0.6. (a) Except for the atrophic lesions of PIC, nothing abnormal was shown on fundus photography. (b) Diffuse hyperautofluorescent patches were detected on SW-FAF, in addition to the hypoautofluorescence of atrophic PIC lesions. (c) Late phase of ICGA was normal in related areas except for some hypocyanescent spots nasal to the optic disc. (d) The visual field examination indicated blind spot enlargement and widespread visual field defects. With relative preservation at the fovea (i), SD-OCT imaging revealed diffuse loss of EZ in the peripapillary zone and in areas that corresponded with the enlarged blind spot. The ONL was preserved (g). Two months later, (e) no obvious change was observed on fundus photography. (f) The intensity of hyperautofluorescence on SW-FAF diminished. (h, j) The EZ reconstructed with focal disruption remained on SD-OCT.
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fig4: Fundus photography (a, e), SW-FAF (b, f), ICGA (c), perimetry (d), and SD-OCT (g, h, i, and j) of the right eye of a 32-year-old female at the initial visit and 2 months later. The presented BCVA was 0.6. (a) Except for the atrophic lesions of PIC, nothing abnormal was shown on fundus photography. (b) Diffuse hyperautofluorescent patches were detected on SW-FAF, in addition to the hypoautofluorescence of atrophic PIC lesions. (c) Late phase of ICGA was normal in related areas except for some hypocyanescent spots nasal to the optic disc. (d) The visual field examination indicated blind spot enlargement and widespread visual field defects. With relative preservation at the fovea (i), SD-OCT imaging revealed diffuse loss of EZ in the peripapillary zone and in areas that corresponded with the enlarged blind spot. The ONL was preserved (g). Two months later, (e) no obvious change was observed on fundus photography. (f) The intensity of hyperautofluorescence on SW-FAF diminished. (h, j) The EZ reconstructed with focal disruption remained on SD-OCT.

Mentions: For the remaining one patient, the diffuse hyperautofluorescent patches on SW-FAF were suggested to be acute zonal occult outer retinopathy (AZOOR) lesions by the following examinations. On funduscopic examination, the correlated areas were normal. The electroretinography (ERG) showed decreased rod and maximal responses. The visual field examination indicated blind spot enlargement and widespread visual field defects. Absence of the EZ was detected in the areas of enlarged blind spot and other visual field defects on SD-OCT. There was no abnormality detected in related areas by FA. During the late phase of ICGA, there was no remarkable finding except some hypocyanescent spots nasal to the optic disc (Figure 4). In the follow-up examination two months later, the intensity of hyperautofluorescence revealed on SW-FAF diminished, and the EZ reconstructed with focal disruption remained on SD-OCT (Figure 4). The patient obtained improved visual acuity and visual field.


The Fundus Autofluorescence Spectrum of Punctate Inner Choroidopathy.

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

Fundus photography (a, e), SW-FAF (b, f), ICGA (c), perimetry (d), and SD-OCT (g, h, i, and j) of the right eye of a 32-year-old female at the initial visit and 2 months later. The presented BCVA was 0.6. (a) Except for the atrophic lesions of PIC, nothing abnormal was shown on fundus photography. (b) Diffuse hyperautofluorescent patches were detected on SW-FAF, in addition to the hypoautofluorescence of atrophic PIC lesions. (c) Late phase of ICGA was normal in related areas except for some hypocyanescent spots nasal to the optic disc. (d) The visual field examination indicated blind spot enlargement and widespread visual field defects. With relative preservation at the fovea (i), SD-OCT imaging revealed diffuse loss of EZ in the peripapillary zone and in areas that corresponded with the enlarged blind spot. The ONL was preserved (g). Two months later, (e) no obvious change was observed on fundus photography. (f) The intensity of hyperautofluorescence on SW-FAF diminished. (h, j) The EZ reconstructed with focal disruption remained on SD-OCT.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig4: Fundus photography (a, e), SW-FAF (b, f), ICGA (c), perimetry (d), and SD-OCT (g, h, i, and j) of the right eye of a 32-year-old female at the initial visit and 2 months later. The presented BCVA was 0.6. (a) Except for the atrophic lesions of PIC, nothing abnormal was shown on fundus photography. (b) Diffuse hyperautofluorescent patches were detected on SW-FAF, in addition to the hypoautofluorescence of atrophic PIC lesions. (c) Late phase of ICGA was normal in related areas except for some hypocyanescent spots nasal to the optic disc. (d) The visual field examination indicated blind spot enlargement and widespread visual field defects. With relative preservation at the fovea (i), SD-OCT imaging revealed diffuse loss of EZ in the peripapillary zone and in areas that corresponded with the enlarged blind spot. The ONL was preserved (g). Two months later, (e) no obvious change was observed on fundus photography. (f) The intensity of hyperautofluorescence on SW-FAF diminished. (h, j) The EZ reconstructed with focal disruption remained on SD-OCT.
Mentions: For the remaining one patient, the diffuse hyperautofluorescent patches on SW-FAF were suggested to be acute zonal occult outer retinopathy (AZOOR) lesions by the following examinations. On funduscopic examination, the correlated areas were normal. The electroretinography (ERG) showed decreased rod and maximal responses. The visual field examination indicated blind spot enlargement and widespread visual field defects. Absence of the EZ was detected in the areas of enlarged blind spot and other visual field defects on SD-OCT. There was no abnormality detected in related areas by FA. During the late phase of ICGA, there was no remarkable finding except some hypocyanescent spots nasal to the optic disc (Figure 4). In the follow-up examination two months later, the intensity of hyperautofluorescence revealed on SW-FAF diminished, and the EZ reconstructed with focal disruption remained on SD-OCT (Figure 4). The patient obtained improved visual acuity and visual field.

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