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L. Amselem, J. S. Pulido, K. Gunduz, S. J. Bakri, M. Diaz-Llopis, J. W. Dolan, K. M. Morgan, S. De Souza, T. Link, J. Rosvold; Fundus Autofluorescence Changes in Choroidal Melanocytic Lesions After Treatment: A Case Series. Invest. Ophthalmol. Vis. Sci. 2007;48(13):133.
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We have previously shown that fundus autofluorescence (FAF) associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) but also to hyperpigmentation, drusen or fibrous metaplasia (Gunduz et al, Bakri et al). We wished to describe FAF changes in choroidal melanocytic lesions before and following treatment.
Retrospective chart review of 5 consecutive patients with choroidal melanoma treated with plaque radiotherapy alone or in combination with transpupillary thermotherapy (TTT) who underwent FAF photography before and after treatment. The correlation between FAF patterns and foci of lipofuscin, hyperpigmentation, drusen, or fibrous metaplasia, defined as a complete correlation, partial correlation or no FAF was evaluated.
The follow-up time was on average 4.5 months (range 3.5 to 7 months). Before treatment, lipofuscin was present in all 5 tumors, hyperpigmentation in 1 tumor and fibrous metaplasia in 3 tumors while drusen were absent in all tumors. After treatment lipofuscin was present in all 5 eyes, hyperpigmentation in all eyes, and fibrous metaplasia in 4 eyes. No drusen were found. Foci of lipofuscin and hyperpigmentation became larger and more numerous after treatment. Fibrous metaplasia also increased. A complete correlation between increased FAF and lipofuscin was found in all 5 tumors (100%) before and after treatment. No correlation between hyperpigmentation and increased FAF was found before treatment but a partial correlation was found in all eyes after treatment. Before treatment, correlation between fibrous metaplasia and increased FAF was partial in 2 eyes (66%), with no correlation in 1 case. After treatment this correlation was partial in all 4 eyes (100%).
Following treatment, choroidal melanocytic lesions show increased FAF mostly due to an increase in the amount of orange pigment (lipofuscin) and hyperpigmentation.
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