The analysis of fundus autofluorescence patterns in retinal diseases

Abstract

Purpose: Fundus autofluorescence (AF) imaging is a method that shows accumulation of lipofuscin in the retinal pigment epithelium cells in vivo. Fundus AF may be recorded in retinal diseases either by scanning laser ophthalmoscope or by fundus camera using the appropriate filter. The aim of this study was to analyze the AF pattern by both methods. Methods: 20 patients with different retinal diseases including retinitis pigmentosa, cone‐rod dystrophy, Stargardt disease, Best macular dystrophy, central serous retinopathy and age‐related macular degeneration were included in the study. AF images were obtained from each subject using a confocal scanning laser ophthalmosope and digital fundus camera. The distribution and amount of AF were compared by the use of both systems. Results: In all disease entities both instruments showed distinct pattern of AF typical for the disease. Areas of high intensity of AF recorded with HRA matched to areas of increased intensity of AF detected with fundus camera. The distribution of areas of low or absent AF also corresponded well in both systems. Images taken with conventional fundus camera were in general lower contrasted and therefore less sharp. This was particularly true for patients with even mild media opacity. The advantage of fundus camera was however a recording of AF of a greater field of view. Conclusions: AF imaging is a very useful noninvasive method for detecting RPE abnormalities. In clinical practice, when scanning laser ophthalmoscope for recording of AF is not available, conventional digital fundus camera can be used for screening of patients suspected to have retinal disease. Care should be taken in patients with nuclear cataract, as the AF image is influenced by the AF of the crystalline lens by a great amount.

Clinical applications of microperimetry in RPGR‐related retinitis pigmentosa: a review

“…The relative hyperautofluorescence is thought to arise from lipofuscin accumulation within a metabolically-stressed retinal pigment epithelium (RPE) supporting degenerating photoreceptors within this transition zone. This hypothesis is supported by abnormal mesopic microperimetry sensitivities at the ring itself; normal sensitivities internal to the ring; and loss of sensitivity radially external to the ring, which has been observed in a cohort of genetically heterogenous retinitis pigmentosa patients (Popovi c et al, 2005;Fleckenstein et al, 2009). A similar but inverse pattern of retinal sensitivity has been shown in RPGRrelated cone-rod dystrophy (CRD), although by static-automated perimetry and electroretingropahy (Robson et al, 2008) and not microperimetry.…”