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Tobias Duncker, Winston Lee, Stephen H. Tsang, Jonathan P. Greenberg, Jana Zernant, Rando Allikmets, Janet R. Sparrow; Distinct Characteristics of Inferonasal Fundus Autofluorescence Patterns in Stargardt Disease and Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2013;54(10):6820-6826. doi: https://doi.org/10.1167/iovs.13-12895.
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© ARVO (1962-2015); The Authors (2016-present)
To report distinct characteristics of fundus autofluorescence (AF) patterns inferior to the optic disc in recessive Stargardt disease (STGD1) and retinitis pigmentosa (RP).
Short-wavelength (SW) and near-infrared (NIR) AF images were acquired from patients with STGD1 and RP. In SW- and NIR-AF images of STGD1 patients, gray levels (GL) on both sides of the demarcation line were measured.
In STGD1, a demarcation line, which has been assigned to the closed optic fissure, was visible on SW-AF and NIR-AF inferior to the optic disc. In healthy subjects, this demarcation line is only visible by SW-AF. At 20° inferior to the disc center, AF levels on the nasal side were 25% (±11%) lower than on the temporal side in SW-AF images and 18% (±11%) lower in NIR-AF images. For both STGD1 and RP, the inferonasal quadrant exhibited distinct SW- and NIR-AF patterns compared with other fundus areas. Disease-related AF changes, such as flecks, appeared to respect the demarcation line as a boundary.
Disease-related AF patterns originating in RPE in STGD1 and RP appear to respect the demarcation line in the inferonasal quadrant of the fundus as a border. The visibility of the inferonasal demarcation line by NIR-AF in STGD1 but not in healthy eyes may indicate that increased levels of RPE lipofuscin modulate the melanin-related NIR-AF signal. This feature of NIR-AF images may aid in the diagnosis of STGD1 patients.
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