Association of Fundus Autofluorescence Findings and Outer Retinal Lesions on Optical Coherence Tomography With Visual Acuity in Birdshot Chorioretinopathy

Abstract

Purpose: This article investigates the optical coherence tomography (OCT) and fundus autofluorescence imaging findings in birdshot chorioretinopathy (BSCR) and their association with visual acuity (VA). Methods: In a retrospective, cross-sectional study, we evaluated OCT images for changes in retinal structure including cystoid macular edema (CME), epiretinal membrane, and outer retinal lesions. We assessed autofluorescence images for hypoautofluorescent and hyperautofluorescent changes and noted the distribution of the lesions. Demographic data and VA at the time of imaging were also collected. Associations between OCT and autofluorescence findings and logarithm of the minimum angle of resolution VA were tested using linear regression. Results: We conducted a chart review of 80 eyes from 40 patients with BSCR. Outer retinal lesions were found on OCT in 28 of 80 eyes (35%) and disruption of the outer segment ellipsoid zone (EZ) occurred in 23 eyes (28.7%). Macular hypoautofluorescent lesions were more common than hyperautofluorescent lesions, present in 58.8% and 13% of eyes, respectively. The presence of outer retinal lesions on OCT was significantly associated with reduced VA ( P = .006) as was EZ disruption ( P = .003). These associations remained significant after accounting for the presence of macular edema. There was a trend toward association of macular hypoautofluorescent lesions with decreased vision, although it was not statistically significant ( P = .17). Conclusions: The association of outer retinal lesions with decreased VA suggests a mechanism of central vision loss that is distinct from CME and may provide an additional objective finding to monitor disease activity in BSCR patients.

Macular Edema and Visual Acuity Observation after Cataract Surgery in Patients with Diabetic Retinopathy

“…At the same time, laser treatment can not only consolidate the visual acuity of patients but also greatly reduce complications. erefore, laser photocoagulation has become a common way to treat diabetic retinopathy, which can effectively occlude the leaky vessels in the macular area and reduce macular edema by water reflux through osmotic pressure, thereby alleviating retinal hypoxia and inhibiting angiogenesis [17][18][19]. However, the curative effect of laser treatment alone is gradually reduced with time and is difficult to last, so it is of great significance to explore treatment methods with strong and lasting effect.…”

Fundus Autofluorescence in Posterior and Panuveitis—An Under-Estimated Imaging Technique: A Review and Case Series

“…Some data suggest that a larger number of choroidal lesions can be identified using a laser with 635 nm excitation wavelength compared to 532 nm [42]. Interestingly, macular hyperfluorescent lesions are not associated with worse LogMAR visual acuity [43]. Also, spectrally resolved autofluorescence imaging can aid in diagnosing BSCR as distinct from similar posterior uveitis entities utilizing the ratio between green and red emission fluorescent components [44].…”

Birdshot Chorioretinopathy: A Review

“…Blue fundus autofluorescence (FAF) identifies lipofuscin accumulation in the RPE and provides information about RPE/photoreceptor health. Hypoautofluorescent lesions are more common than hyperautofluorescent lesions in BSCR patients ( Figure 2 ) [ 40 ]. The most common pattern is the peripapillary confluent hypoautofluorescence described in around 70% to 80% of BSCR patients [ 41 , 42 , 43 , 44 ].…”