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Robert Chun, Frederick Collison, Michele May, Gerald Fishman; The Value of Retinal Imaging and Functional Testing of Patients with Stargardt Disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3626.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate Stargardt disease patients by correlating structural abnormalities, visualized with infrared scanning laser ophthalmoscopy (SLO) and fundus autofluorescence (AF) imaging, with functional changes on microperimetry (MP).
Forty eyes of 20 patients with Stargardt disease were studied using SLO, spectral domain optical coherence tomography (SD-OCT), macular MP, fundus photography, and AF.
While AF imaging outlined regions of RPE atrophy and enhanced the visibility of more funduscopically apparent flecks, SLO infrared imaging effectively idenitified regions of RPE and choroidal atrophy. Degenerative changes in photoreceptor and RPE cell layers, evident on OCT imaging, were associated with either hyporeflective or hyperreflective images on SLO infrared imaging, depending on whether both RPE and choroidal atrophy (hyperreflectance) or solely RPE atrophy (hyporeflectance) was present. Greatest threshold elevations on MP testing corresponded to RPE and choroidal atrophy as indicated on SLO (hyperreflectance) and RPE atrophy on AF (hypoautofluorescence). Visual function was often better preserved in retinal regions that corresponded to visually evident fundus flecks.
SLO imaging is a valuable procedure for evaluating the structure of the RPE and choroid. AF localizes areas of enhanced lipofuscin accumulation and regions of RPE atrophy. SLO and AF imaging, coupled with MP, can provide complementary roles for monitoring patients during treatment trials and for determining the natural progression of disease.
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