Multimodal imaging in Rubella Retinopathy

Abstract

Purpose: To demonstrate multimodal imaging features of rubella retinopathy.

Methods: Five patients (age 8 to 49 years) with salt-and-pepper retinopathy and varying degree of hearing loss underwent complete ophthalmic examination and multimodal imaging including wide-field scanning laser ophthalmoscopy, fundus autofluorescence and spectral domain optical coherence tomography (OCT) (Spectralis, Heidelberg). Two patients also underwent electrophysiology and 10-2 MAIA microperimetry. Adaptive optics (AO) imaging (rtx1, Imagine Eye) was performed in one patient to document cone mosaic.

Results: Mean visual acuity was 81 and 79 letters in R and L eyes. drusen-like structures were present in the macular region in all eyes. Some of these corresponded to the hyper autofluorescent spots. Speckled hypo autofluorescent regions were seen within the posterior pole extending to the periphery to variable extent. OCT showed subretinal and sub-RPE lesions with diffuse stippled discontinuity within the ellipsoid band in the macular region. Average macular retinal sensitivity was 28.7 dB in 4 eyes that underwent microperimetry. Electrophysiology showed mild generalised cone and rod dysfunction. Adaptive optics imaging showed reduced cone density in the perifoveal region .

Conclusions: Hyper autofluorescent spots and diffuse speckled hypo autofluorescence are common features in rubella retinopathy. Multimodal imaging may aid clinical diagnosis of this rare condition.