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Chad Hummel, Sandeep Grover, UF College of Medicine - Jacksonville; Spectral Domain Optical Coherence Tomography and Fundus Autofluorescence in Patients with Rubella Retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3385.
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Patients with rubella retinopathy clinically show a "salt and pepper" appearance on fundus exam. Typically, these patients do not show any functional impairment of retinal function. This is proposed to be due to changes in the retinal pigment epithelium (RPE). Fundus autoflourescence is an effective method of imaging changes in the RPE. This case series describes the spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) findings in patients with rubella retinopathy.
This is a retrospective chart review and three patients with known diagnosis of rubella retinopathy were identified. All these patients had documented normal visual function and SD-OCT and FAF had been performed. The SD-OCT and FAF records were reviewed and visual acuity and central subfield thickness on SD-OCT were documented. The FAF was studied and a qualitative assessment was made.
Clinically, 2 out of 3 patients had bilateral rubella retinopathy while 1 patient had unilateral retinopathy, based on the presence of ‘salt and pepper’ changes on fundus photograph. The visual acuity was normal in all these patients. The macular thickness and structure of the retina, including the photoreceptors and RPE was normal in all eyes of all patients. FAF showed areas of ‘patchy autofluorescence’ with a stippled hypoautofluoresence on FAF corresponding to the areas of hyperpigmentation on clinical exam. It was interesting that in the patient who had rubella retinopathy in one eye, it was doubtful on clinical exam whether she truly had unilateral retinopathy or bilateral asymmetrical retinopathy. The FAF confirmed that it was truly unilateral with the clinically normal-looking eye showing a normal autofluorescence.
SD-OCT and FAF are useful diagnostic tools that effectively illustrate the retinal pigment epithelium changes seen in patients with rubella retinopathy and can help in clinical scenarios.
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