Abstract
Purpose :
Retinoschisis (RS) is occasionally difficult to distinguish from a retinal detachment (RD) on ophthalmologic examination. Optical coherence tomography (OCT), the gold standard imaging modality, is limited to the posterior pole and may not be able to capture more peripheral abnormalities. Wide-field fundus autofluorescence (WF-FAF) has been proposed as an additional imaging modality that may help differentiate between RS, RD, or combined RS/RD lesions based on autofluorescence patterns. The purpose of our study is to characterize the pattern of WF-FAF images and correlate these findings with spectral domain OCT (SD-OCT) to determine if autofluorescence patterns can reliably distinguish RS from RD.
Methods :
This study was a retrospective chart review of patients who were diagnosed with either RS or RD between February 2013 and November 2018. Patients were excluded if they had vitreoretinal diseases other than RS or RD, or if they did not have both WF-FAF and SD-OCT performed on the same visit through the area of RS or RD. WF-FAF images were first analyzed and determined to have either hypoautofluorescence (hypo-AF) or “mixed autofluorescence” (mixed-AF), which was defined as hypo-AF with isoautofluorescence (iso-AF), hyperautofluorescence (hyper-AF) with iso-AF, or hyper-AF with hypo-AF. SD-OCT images from the same eye were then analyzed to confirm areas of RS, RD, or combined RS/RD. Autofluorescence patterns were then compared to SD-OCT results to determine if there was a correlation between autofluorescence and type of retinal abnormality.
Results :
Eight of ten (80%) eyes demonstrated mixed-AF on WF-FAF and two (20%) exhibited hypo-AF only. Of the eyes demonstrating mixed-AF on WF-FAF, all were confirmed to have either an RD or combined RS/RD on SD-OCT. The two eyes that exhibited only hypo-AF were confirmed to have only RS on SD-OCT.
Conclusions :
Hypo-AF on WF-FAF appears to correspond to areas of pure RS, while mixed-AF correlates with either RD or combined RD/RS. While OCT remains the gold standard imaging modality in distinguishing RS from RD, WF-FAF may be a useful tool when OCT is unable to image peripheral abnormalities to determine if areas of RD are present and to monitor areas of RS over time.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.