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Marco Pellegrini, Elisa Carini, Antonio Peroglio Deiro, Marta Oldani, Giovanni Staurenghi; Angiographic Findings In Stargardt Disease: A Multimodalities Approach. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5018.
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Purpose of the study was to define and compare different imaging modalities in Stargardt Disease.
24 eyes from 12 consecutive patients affected by Stargardt Disease were evaluated using two different confocal scanning laser ophthalmoscopes (HRA2 and Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany) in order to compare Fundus Autofluorescence (FAF), Fluorescein and Indocyanine Green angiography (FA and ICGA) findings; color fundus photography and SD-OCT were also performed to better characterize angiographic features.
Patient mean age was 50 years (range 17-78 years) and mean visual acuity 20/100 (range 20/800-20/25). At FA and Fundus Autofluorescence (FAF) examinations 16 eyes showed Overt Atrophic Macular Lesions (group 1) while 8 had Not Overt Macular Atrophy (group 2); group 2 eyes had the same visual acuity of group 1. Dark choroid was detected in 18 eyes (87% of group 1 and 50% of group 2). At FAF 62.5% of eyes belonging to group 1 showed an iperfluorescent ring around the central atrophic lesions while 100% presented an iperfluorescence of atrophy margins in FA. In Late-Phase ICGA (20-40 minutes since dye injection) atrophy appeared as an area of decreased fluorescence showing dark choroidal vessels and transparent margins. Group 2 eyes did not show any iperfluorescent boundary neither in FAF nor FA. In ICGA they appeared as an irregular area of decreased fluorescence with no evident vessels below. In 33.3% the size of macular lesions appeared wider in Late-Phase ICGA than in FAF/AF. Middle-Late phase ICGA revealed also the presence of tiny iperfluorescent dots in 100% of eyes: these showed the same location of retinal flecks, which appeared in ICGA to mask background fluorescence.
Combined examination using different imaging techniques allowed a more complete evaluation of Stargardt Disease angiographic findings. The presence of characteristic features detectable in almost all patients suggests they could be pathognomonic for this condition; however the real meaning of these signs remains to be defined.
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