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L. Amselem, J. S. Pulido, K. Gündüz, J. García-Arumí, J. Monés, F. Huste, R. Abreu, M. J. Romero; Short-wavelength Fundus Autofluorescence and Near-infrared Reflectance of Choroidal Tumors. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5232.
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Choroidal tumours are associated with several degenerative changes in the overlying tissues. These changes have been called "Tumour-Associated Retinal Pigment Epitheliopathy" (TARPE). The presence of lipofuscin (orange pigment) is a sign of retinal pigment epithelial distress. The purpose of this study is to describe short-wavelength fundus autofluorescence (SW-FAF) and near-infrared reflectance (IRR) findings in choroidal tumors.
Retrospective chart review of 44 consecutive patients with choroidal tumors who underwent SW-FAF and IRR photography. The correlation between SW-FAF and IRR patterns and foci of orange pigment, hyperpigmentation, drusen, fibrous metaplasia and subretinal fluid, was evaluated.
The mean patient age was 65. Twenty-nine patients had a choroidal melanoma, 9 patients had choroidal metastasis, and 6 patients had a choroidal hemangioma. All tumors showed many foci of increased SW-FAF and/or increased IRR. Orange pigment displayed the brightest SW-FAF and was hyperreflective in IRR imaging. IRR imaging highlighted the presence of condensed clumps of orange pigment, presenting a good correlation with SW-FAF imaging, but barely detected diffuse fine lipofuscin. Related RPE hyperplasia and atrophy were isoreflective with the normal fundus, showing low correlation with SW-FAF, where they appeared mainly hypofluorescent. Lipid exudates and drusen were hyperreflective in IRR imaging and difficult to distinguish from the orange pigment, creating a "confusion factor". Fibrous metaplasia was mainly hyperreflective while it was hypofluorescent in SW-FAF imaging. Subretinal fluid was barely visible in IRR imaging, while SW-FAF imaging highlighted its presence. The top of dome-shaped surfaces in the fundus were usually hyperreflective, creating an artifact that didn't exist in SW-FAF imaging.
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