Lipofuscin Autofluorescence in Multiple Evanescent White Dot Syndrome

Abstract

Abstract: : Purpose: Confocal scanning laser ophthalmoscopy allows clinical examination of lipofuscin autofluorescence in retinal pigment epithelium (RPE). The present study examined lipofuscin autofluorescence of patients with multiple evanescent white dot syndrome (MEWDS). Methods: Heidelberg retina angiography (HRA) was used to examine 3 eyes of 3 patients within 2 weeks of initial symptom. MEWDS was diagnosed based on findings from ophthalmoscopy, fluorescein angiography (FA) and indocyanine green angiography (IA). Images were obtained at 10 frames/s. After selecting 8 consecutive images, additive syntheses were obtained using software. Results: White spots in the deep retina were noted on ophthalmoscopy. FA revealed normal and hyperfluorescence through angiography, while IA showed hypofluorescence in the late phase. HRA demonstrated normal to high lipofuscin autofluorescence in and surrounding areas of white spots. No areas of lipofuscin hypofluorescence were observed. In 1 eye on follow–up examination, lipofuscin hyperfluorescence was increased at 4 weeks compared with that at 2 weeks, but normalized by 2 months. Conclusions:Increased lipofuscin autofluorescence and no hypofluorescence of the RPE were probably related to increased RPE metabolism in the acute stages of MEWDS. Evaluation of lipofuscin autofluorescence may provide additional information regarding the pathophysiology of MEWDS.

Keywords: retinal pigment epithelium • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)