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I. A. Barbazetto, K. B. Freund, L. A. Yannuzzi; Fundus Autofluorescence Patterns in Patients With High Myopia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):265.
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To investigate fundus autofluorescence (AF) characteristics in patients with high myopia.
Retrospective, observational case study of patients diagnosed with high myopia who underwent fundus photography and AF imaging as part of their clinical work-up. Fluorescein angiography and /or fourier-domain optical coherence tomography were examined to confirm presence or absence of choroidal neovascularization (CNV). AF images were qualitatively evaluated and correlated to clinical and imaging findings.
116 eyes of 59 patients (25 male, 34 female) with a mean spherical equivalent of -12.3 diopters (range: -5 to -30dpt) were included in this study. AF patterns were defined as peripapillary hypoautofluorescence (n=115/ 99.1%), round or lobular AF patterns (n=76/ 65.5%), diffuse granular or speckled patterns (n=91/ 78.5%) and linear patterns of AF abnormalities (n=46/ 39.7%). 54 eyes had CNV. Average visual acuity (VA) in the entire study group measured 20/200 (20/25 - 5/400). CNV predicted poor VA (average 20/400 compared to 20/60). In eyes without CNV (n=62) the presence of round-lobular AF patterns (n=34) was associated with lower VA when compared with patients without this finding (p=0.021). Speckled or linear AF patterns were not associated with changes in VA. 51 eyes had additional examinations with an average follow-up of 25 months (4-71months). During this time, progressive peripapillary enlargement of AF changes was seen in 23 eyes (45%). Progressive enlargement of round-lobular patches was found in 26 eyes (50.9%).
Patients with high myopia present with distinct patterns of AF abnormalities related to CNV or associated with posterior staphyloma and choroidal thinning. Although technically more challenging in high myopia, AF imaging can monitor such patterns and may aid as an additional tool in predicting visual deterioration in the future.
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