Quantitative Analysis of Adult Onset Foveal Vitelliform Lesions with Multimodal Imaging

Abstract

Purpose : Adult-onset vitelliform foveal dystrophy (AOFVD) is associated with a yellowish subretinal deposit at the fovea leading to vision loss. At present there is no way to quantify these lesions within the retina. We performed a retrospective cross-sectional pilot study of AOFVD patients. This study aims to demonstrate a way to quantitatively analyse these lesions using new multimodality imaging and compare the morphology of lesions within different stages of the disease.

Methods : All patients presenting to our department with a new or existing diagnosis of AOFVD between January and June 2016 were included in the study. All patients underwent clinical examination, fundus photography and SS-OCT scans with a Triton OCT (Topcon). Images were analysed using Topcon ImageNet6 software. Macular subfield choroidal thickness maps were assessed and maximal lesion height was manually measured. Base, mid and apical lesion areas were measured with en-face SS-OCT. Where available, lesion area was also measured from autofluorescence scans. Statistical comparison was performed with Wizard Pro v.1.8.28.

Results : 20 eyes (10 patients) aged 51-95 years with a diagnosis of AOFVD were included. 13 patients had vitelliform stage, 6 had atrophic stage and 1 had vitellerruptive stage disease. The mean height of vitelliform stage lesions was not significantly higher than atrophic lesions (130±32.7μm vs 107.8±6 μm, p=0.323, Mann-Whitney). No significant difference was noted in RPE, mid-retina and apical cross sectional areas on en-face SS-OCT between vitelliform stage and atrophic stage lesions (p=0.579/0.416/0.765, Mann-Whitney). No significant difference was noted in macular subfield choroidal thickness (p=0.966, Mann-Whitney). Mean RPE level area on SS-OCT was larger that AF area (1.6±0.9 vs 1.11±1 mm²) but with strong positive correlation (p<0.001, Fisher test).

Conclusions : Our study demonstrates that SS-OCT can provide quantitative data on AOFVD lesions. There was a positive correlation with autofluoresence lesion measurements. There was no significant difference noted in the dimensions and areas of lesions between different stages. Choroidal thickness does not appear to be affected throughout the different stages of AOFVD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.