April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Fundus Autofluorescence Patterns in Deferoxamine Maculopathy: Morphological Evaluation and Natural Course
Author Affiliations & Notes
  • G. Barteselli
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • F. Viola
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • E. Villani
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • L. Dell'Arti
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • D. Vezzola
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • V. Canton
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • R. Sala
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • F. Magnani
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • M. Cappellini
    Clinica Ematologica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • R. Ratiglia
    Clinica Oculistica,
    Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Università di Milano, Milan, Italy
  • Footnotes
    Commercial Relationships  G. Barteselli, None; F. Viola, None; E. Villani, None; L. Dell'Arti, None; D. Vezzola, None; V. Canton, None; R. Sala, None; F. Magnani, None; M. Cappellini, None; R. Ratiglia, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 323. doi:
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      G. Barteselli, F. Viola, E. Villani, L. Dell'Arti, D. Vezzola, V. Canton, R. Sala, F. Magnani, M. Cappellini, R. Ratiglia; Fundus Autofluorescence Patterns in Deferoxamine Maculopathy: Morphological Evaluation and Natural Course. Invest. Ophthalmol. Vis. Sci. 2010;51(13):323.

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Abstract

Purpose: : To describe and classify patterns of abnormal fundus autofluorescence (FAF; excitation 488nm, emission > 500nm) and their natural progression in eyes with deferoxamine maculopathy.

Methods: : 14 consecutive thalassemic patients with deferoxamine maculopathy (27 eyes) were included. FAF images were performed with a confocal scanning laser ophthalmoscope (HRA2 Spectralis, Heidelberg Engineering). The patterns of fundus alterations detected by FAF were evaluated and their progression was analyzed.

Results: : All patients showed alterations in FAF, classified into four phenotypic patterns including minimal change (12 eyes), focal (5 eyes), patchy (6 eyes) and speckled (4 eyes). Areas of abnormal increased or decreased FAF signals could correspond or not to visible alterations in indirect ophthalmoscopy. In 18 of 27 eyes, the alterations in FAF progressed beyond the vascular arcades, in the other cases were confined to the macula. During follow up (mean 11 months, range 3-26 months) patchy pattern showed a marked progression of abnormalities in 2 out of 3 patients, who developed retinal pigment epitelium atrophy. The only patient with patchy pattern who could discontinue the treatment, partial regression occurred. Speckled pattern showed slight changes in FAF, while minimal change and focal patterns didn’t show any change. Visual acuity was significantly reduced in eyes with patchy pattern, showing a progressive decrease during the follow up if the treatment was not discontinued. No significant decrease of vision occurred in other patterns during the follow up.

Conclusions: : FAF is a non-invasive and valid imaging method exam for early detection of retinal pigment epithelium abnormalities in deferoxamine maculopathy and can be used to monitor the status of the macula in patients at risk for this toxicity. Patterns of FAF may indicate different stages of maculopathy and could be useful as a guide for discontinuing or switching the treatment.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • drug toxicity/drug effects • ipofuscin 
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