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Klaus Rohrschneider, Alexander F. Scheuerle; Autofluorescence Imaging And Spectral-Domain Optical Coherence Tomography In Hereditary Chorioretinal Diseases. Invest. Ophthalmol. Vis. Sci. 2012;53(14):824.
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To compare fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT) appearance in different chorioretinal diseases.
150 eyes of 84 patients with different chorioretinal diseases (retinitis pigmentosa, cone rod dystrophy, cone dystrophy, achromatopsia, Stargardts disease) which were diagnosed by full-field electroretinography, multifocal electroretinography, fundus appearance and extensive functional tests were evaluated with SD-OCT and FAF using a confocal scanning laser ophthalmoscope (Spectralis, Heidelberg Engineering). Obvious changes of retinal layers were compared with specific autofluorescence imaging in a 30 degree view.
While there are age-dependent changes in the results, some findings were typical for specific diseases. In 23 of 28 eyes with RP a typical ring of increased FAF corresponding with loss of the inner segment/outer segment junction was found. Besides all eyes of Stargardts disease (n=26) mottling FAF and thickening of the basal membrane was found in 16 out of 28 eyes with cone rod dystrophy. Imaging in achromatopsia and advanced cone dystrophy showed very similar results. In early stages subfoveal changes of photoreceptor layer corresponding to increased FAF were unspecific findings. The area of FAF alteration correlated to photoreceptor changes in RP and CRD patients. Measurement of retinal thickness and especially retinal layers often might be difficult caused by diffuse alteration of the retina in advanced stages of RP.
Advanced imaging techniques like FAF and SD-OCT allow further insight in hereditary chorioretinal diseases and especially in clinically similar but genetic different entities. Although ERG testing remains the gold standard for the diagnosis of these conditions, FAF and SD OCT systems are more widely available to community ophthalmologists, offer shorter acquisition times, and may provide more detailed information of circumscribed pathology. This might be helpful in further genotype-phenotype correlation and more specific diagnosis and follow-up of chorioretinal disease even in young patients with only minor morphologic and functional changes.
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