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Ashvini Reddy; Fundus Autofluorescence in Acute Retinal Necrosis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5871.
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Acute retinal necrosis (ARN) is an extremely rare, rapidly progressive viral infection of the retina. Because it is uncommon, management is often guided by case reports and small case series. The use of fundus autofluorescence imaging to monitor disease progression has not been previously described. The purpose of this research is to report the utility of autofluorescence in monitoring ARN.
Case report. A patient with viral ARN had serial fundus photos, macular optical coherence tomography (OCT) scans, fluorescein angiograms, and autofluorescence images taken at presentation and over a four month period. Clinical data including demographics, examination findings, interventions, and response to treatment were also reviewed. Images from each modality were compared for sensitivity at detecting retinal involvement in the periphery and at the posterior pole.
Fundus autofluorescence allowed visualization of retinal involvement at the posterior pole and identification of the disease margin on initial presentation. Using autofluorescence, it was possible to follow the advancing disease margin until progression was arrested following administration of systemic antiviral medication and oral steroids. Fundus autofluorescence was superior to clinical examination, fundus photography, fluorescein angiography, and OCT in detection of retinal involvement.
Fundus autofluorescence appears more sensitive to disease progression in ARN than fundus photography, OCT, and fluorescein angiography. Because this disease tends to progress rapidly, serial examinations with autofluorescence could be used to detect areas of involvement and identify advancing margins of disease even before they are apparent on clinical examination or identifiable on other imaging modalities.
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