Fundus Autofluoresence and Spectral Domain OCT Findings at the Junction between the Altered and Normal Chorioretina in Patients with Tilted Disc Syndrome

Abstract

Purpose: : To elucidate fundus autofuoresence (FAF) and the spectral domain optical coherence tomography (SD-OCT) findings at the junction between the altered and normal chorioretina in patients with tilted disc syndrome.

Methods: : 22 eyes of 11 patients having tilted disc syndrome with inferior staphyloma were examined with confocal scanning laser ophthalmoscope and SD-OCT (HRA-OCT Spectralis, Heidelberg Engineering). The near-infrared, FAF, fluorescein angiography or indocyanine green angiography image and the SD-OCT image were compared using the point-to point correlation feature of HRA-OCT Spectralis. Each section comprised of more than 20 averaged scans.

Results: : On FAF, the macular area of border of inferior staphyloma showed normal background fluorescence. Concomitant lesions of increased fluorescence and of distinct belt-like hypofluorecence (hypo FAF) were seen in 9 eyes and 13 eyes, respectively. On SD-OCT, serous retinal detachment (SRD) was observed in 10 eyes, and detached retinal pigment epithelium (RPE) from Bruch’s membrane was seen at the border area of inferior staphyloma in 12 eyes. These findings were found in 13 eyes with hypo FAF. In other 9 eyes without hypo FAF and one eye with hypo FAF, neither SRD nor RPE detachment were observed. Localized reflective deposits and irregular reflectivity were seen between the IS-OS line and RPE layer at the border area of inferior styaphyloma.

Conclusions: : Hypo FAF was associated with a degree of the RPE disorders and SD-OCT demonstrated morphological changes in photoreceptor and RPE layers at the border area of inferior staphyloma. These changes were probably caused by the different curvatures of outer retina and choroid associated with staphyloma. Careful follow-up may be necessary because of possible development of occult choroidal neovasularizaiton in eyes with hypo FAF and the RPE detachment.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid: neovascularization • retina