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P. Karadimas, A. Goritsa, G.P. Paleokastritis, A. Kotzabassis, E.A. Bouzas; Autofluorescence Imaging in Central Serous Chorioretinopathy and Correlation With Fluorescein Angiography and Indocyanine Green Angiography . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3463.
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Purpose: Recording of fundus autofluorescence (AF) is a novel technique of retinal imaging. The aim of this study was to record AF imaging in the various subtypes of central serous chorioretinopathy (CSCR). In addition, we correlated these findings with those obtained from fluorescein angiography (FA) and indocyanine green angiography (ICG), in order to clarify their significance. Methods: 28 eyes of 22 patients (16 men, 6 women) with CSCR were included. For the purposes of this study the disease was classified in two types: a) the ‘typical’, characterized by the presence of a leaking point or minimal abnormalities (less than 1 disk area) of the retinal pigment epithelium (RPE) in FA accompanied by a serous detachment of the neurosensory retina, and b) the ‘diffuse retinal pigment epitheliopathy’, characterized by the presence of extensive abnormalities of RPE (more than 1 disk area) in FA. This category was further subdivided in active and inactive disease, according to the additional presence of a leaking point or not. AF imaging was recorded by means of a confocal scanning laser ophthalmoscope (HRA 2, Heidelberg Engineering, Germany). FA and ICG were recorded using the same instrument. Results: In cases with typical CSCR (n=10), AF inside the area of the neurosensory detachment was decreased, as compared to the rest of the fundus. In addition, some of the eyes (n=5, 50%) exhibited multiple pinpoints of increased AF inside this area, not corresponding to FA abnormalities. The leaking point was present in AF imaging as a dark spot or as a target lesion (dark center surrounded by a hyperfluorescent ring). In cases with diffuse retinal pigment epitheliopathy (n=18), areas of irregular pattern of AF (increased and decreased) were recorded. These areas were more extended if compared to funduscopy and comparable to FA findings. However, in some eyes (n=8, 44%) additional extensive zones of homogenous high AF, not corresponding to any FA abnormalities, were observed. ICG in both variants of the disease showed one or more areas of choroidal hyperperfusion. However, there was no correlation between AF imaging and ICG findings. Conclusions: AF imaging of the fundus can be recorded in patients with CSCR in a fast and non invasive manner. In this study we found that this technique provides information additional to that obtained by FA and ICG. More studies are required in order to clarify the significance of this new information in the pathogenesis, natural history and prognosis of the various subtypes of the disease.
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