Abstract
Purpose: :
We have previously shown that fundus autofluorescence (FAF) improves visualization of lipofuscin (orange pigment) and subretinal fluid in pigmented choroidal melanomas in comparison with conventional fundus photography. The purpose of this study is to describe infrared reflectance (IRR) imaging findings in choroidal melanomas and compare them with those obtained by FAF imaging.
Methods: :
Retrospective chart review of 6 consecutive patients with choroidal melanoma who underwent FAF and IRR photography. The correlation between IRR and FAF patterns and foci of orange pigment, hyperpigmentation, lipid exudates, fibrous metaplasia and subretinal fluid, was evaluated.
Results: :
Orange pigment is hyperreflective in IRR imaging. IRR imaging highlights the presence of condensed clumps of orange pigment, presenting a good correlation with FAF imaging, but hardly detects diffuse fine lipofuscin. Hyperpigmentation is isoreflective with the normal fundus, showing low correlation with FAF, where they appear mainly hypofluorescent. Lipid exudates are hyperreflective in IRR imaging and difficult to distinguish from the orange pigment, creating a "confusion factor". Fibrous metaplasia is mainly hyperreflective while it is hypofluorescent in FAF imaging. Subretinal fluid is not visible in IRR imaging, while FAF imaging highlights its presence. The top of dome-shaped surfaces in the fundus is usually hyperreflective, creating a "noise factor" that doesn't exist in FAF imaging.
Keywords: melanoma • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • ipofuscin