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Ari Dylan Schuman, Tobias Duncker, Winston Lee, Rando Allikmets, Janet R Sparrow, Donald C Hood, Vivienne C Greenstein; Comparing Near-Infrared and Short-Wavelength Autofluorescence in Recessive Stargardt Disease to Retinal Structure. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1429.
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© ARVO (1962-2015); The Authors (2016-present)
To compare hypoautofluorescent (hypoAF) areas detected with near-infrared (NIR) and short-wavelength autofluorescence (SW-AF) in patients with recessive Stargardt disease (STGD1) to retinal structure using spectral domain optical coherence tomography (OCT).
Macular volume and line scans were obtained from 7 patients (7 eyes); age 12-44 yrs with genetically confirmed STGD1, and from 15 control eyes using Spectralis HRA+OCT (Heidelberg Eng.). SW-AF (488nm) images were acquired with the Spectralis, and NIR-AF (787nm) images with the Heidelberg Retina Angiograph 2 (Heidelberg Eng). The AF images were registered to the fundus image of the OCT using i2kRetina software (DualAlign LLC). Volume scans of the patients and controls were segmented using an automated program with manual correction.[1, 2] The thicknesses of the outer segment plus (OS+) layer, from the ellipsoid zone (EZ) to the distal border of the retinal pigment epithelium, and the total retina (TR) were calculated. Thickness maps of the OCT scans and contour maps of the locations where the EZ disappeared were created. These were overlaid on their respective NIR and SW-AF images using Adobe Photoshop.
All 7 patients had hypoAF areas in the central macula. In agreement with previous studies, the abnormal AF areas appeared to be larger on NIR-AF than SW-AF.[3,4] For 3 patients, the central hypoAF region on NIR-AF was surrounded by a hyperautofluorescent (hyperAF) ring which was encircled by a diffuse hypoAF area. Four patients had hypoAF flecks on NIR-AF, which were hyperAF on SW-AF. The TR and OS+ thickness maps showed progressive thinning from the periphery (+/-3 mm) towards the central fovea. Superimposition of the thickness maps on the NIR and SW-AF images showed that AF flecks and diffuse hypoAF areas outside the central atrophic lesion were associated with OS+ thinning. Superimposition of the EZ contour maps on their respective NIR and SW-AF images showed that the central hypoAF area on NIR-AF provided a better approximation of the area of EZ loss.
These results indicate that NIR-AF and thickness maps of OCT volume scans provide additional information about the nature of the disease process in STGD1. 1. Yang et al. Biomed Opt Exp, 2011; 2. Raza et al. Arch Ophthalmol, 2011; 3. Kellner S et al. AJO, 2009; 4. Lee et al. ARVO 2013.
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