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M. Camparini, P. Cassinari, C. Macaluso; Autofluorescence of Cystoid Macular Edema. A HRA Scanning Laser Ophthalmoscope Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4952.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate whether fundus autofluorescence as imaged with a scanning laser ophthalmoscope is affected in cystoid macular edema (CME), and to evaluate its correspondence to fluorescein angiography images. Methods: The Heidelberg Retina Angiograph (HRA) confocal scanning laser ophthalmoscope was used to acquire pictures of the macular region in autofluorescence (AF) and fluorescein angiography (FA) modes in 30 patients affected by CME of different origin: post-cataract surgery, diabetic, inflammatory, associated with retinal vein occlusion or epiretinal membrane. To improve signal to noise ratio, 4 to 32 images at 512x512 pixel resolution were averaged. In five cases both AF and FA were re-examined after resolution of CME. Results: In all cases, of the cysts accumulating fluorescein, the most central invariably showed increased autofluorescence. The autofluorescent pattern of these cysts was perfectly corresponding in shape to the angiographic image. Interestingly, these central cysts, together with autofluorescence, always showed a more round shape and a less intense accumulation of fluorescein as compared to more peripheral cysts. In those cases where a resolution of CME was observed, no more autofluorescent cysts were detected, accordingly to the fluorescein angiography pattern. Conclusions: The fact that increased autofluorescence is consistently observed in CME of different origin, and the good correlation with fluorescein angiography images, indicate that this non-invasive examination might be useful in the diagnosis and follow-up of this common complication. As retinal AF is generally attributed to lipofuscin in the RPE, the present finding raises a question about the origin of such material in the central cystic lesions, and about the exact localization of CME cysts within the retina.
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