High-resolution Imaging Of The White Dot Structure Observed In Fundus Albipunctatus

Abstract

Purpose: : To investigate the microstructures of the white dots observed in fundus albipunctatus by using spectral-domain optical coherence tomography (SD-OCT) and adaptive optics scanning laser ophthalmoscopy (AO-SLO)

Methods: : Six eyes of 3 patients with fundus albipunctatus underwent a complete ophthalmologic examination, including SD-OCT and AO-SLO. The localization of the white dots seen on fundus photography was determined through SD-OCT. The morphological characteristics (such as density and arrangement), observed through AO-SLO, inside and outside the areas corresponding to the white dots seen on fundus photography were compared.

Results: : SD-OCT showed hyper-reflective lesions (n = 337) in the areas corresponding to the white dots as seen on fundus photography. These hyper-reflective lesions were observed between the retinal pigment epithelium (RPE) and the photoreceptor inner segment/outer segment junction (IS/OS) in 7%, had broken through the IS/OS and were seen between the RPE and the external limiting membrane (ELM) in 68%, and had broken through the IS/OS and ELM in 25%. AO-SLO showed hyper-reflective mosaic surrounded by dark areas in the area corresponding to the white dots seen on fundus photography. These hyper-reflective mosaics were similar to the surrounding cone mosaics; however, the density and arrangement (the ratio of the nearest neighbor distance [NND] and the expected NND) differ between the inside and outside of the areas corresponding to the white dots (P = 0.003 and P < 0.001).

Conclusions: : SD-OCT and AO-SLO showed hyper-reflective lesions in the areas corresponding to the white dots as seen on fundus photography. Moreover, hyper-reflective lesions were observed on the RPE. The observed hyper-reflective mosaics were similar to the cone mosaics, although the density and arrangement were different. These findings suggest that white dots observed in fundus albipunctatus may be subretinal OS-like deposits.

Keywords: imaging/image analysis: clinical • retina