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Viola Graham, Monika Fleckenstein, Katharina Zilkens, Steffen Schmitz-Valckenberg, Frank Holz; Long-term follow-up of fundus autofluorescence and multi-spectral reflectance imaging using ultra-widefield scanning laser ophthalmoscopy in patients with different retinal pathologies. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5838.
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To evaluate peripheral changes in retinal pathologies over a period of three years by using an ultra-widefield scanning laser ophthalmoscope (SLO) for fundus autofluorescence (FAF) and color fundus imaging.
Longitudinal FAF and multi-spectral reflectance ultra-widefield imaging were performed in 14 eyes from 7 patients with different retinal pathologies (mean age 60 years, range 22-81). In 2009, we used an Optos P200CAF prototype and in 2012 an Optos 200Tx (Optos Ltd, Scotland). Images were evaluated for quality and changes in signal distribution of central and peripheral retinal lesions. Retinal pathologies included age-related macular degeneration (AMD), Stargardt disease, angioid streaks and other hereditary retinal dystrophies.
In AMD, progression of existing and development of de-novo peripheral atrophic spots beyond the vascular arcades were observed in addition to central lesion evolution. In rod-cone dystrophy and angoid streaks secondary to Pseudoxanthoma elasticum, increase in area involvement of mid-peripheral decreased FAF signal alterations were visible. In a patient with advanced Stargardt disease, both increase in atrophic lesion size and focally increased FAF abnormalities beyond the vascular arcades were detected. In a patient with unilateral unknown periphal atrophy, no changes in lesion size were visible.
Ultra-widefield scanning laser ophthalmoscopy imaging allows for the visualization of the evolution of both central and peripheral lesions in one image. Changes in levels of peripheral decreased FAF may be helpful to predict localized retinal dysfunction. This may be helpful for the assessment and long-term follow-up of patients with retinal lesions which extend into the periphery.
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