Fundus autofluorescence in premature infants

Abstract

Purpose : To describe fundus autofluorescence (FAF) patterns in newborn patients taken with an ultra-widefield laser ophthalmoscope.

Methods : Retrospective, descriptive case series of infants who were screened for retinopathy of prematurity (ROP). We included cases where ROP required observation only (Zone III, Stage 1 or 2), and had FAF images available. Evaluation of the images was done by two retina specialists in a blind manner. Images were graded in a dichotomic fashion (yes/no) according to the following parameters:
Presence or not of FAF, in general?
Optic nerve hypoautofluorescence visible?
Foveal hypoautofluorescence visible?
Peripapillary vessels hypoautofluorescence visible?
Equatorial vessels hypoautofluorescence visible?

Results : Fourteen patients from 36 to 62 weeks of corrected gestational age were included. In younger infants very poor fundus autofluorescence was noted, with barely visible contrast between the retina and blood vessels (peripapillary vessels visible in 78.6% of cases, with 48.5 weeks of mean corrected age, and equatorial vessels vissible in 42.8% of cases with 56.6 weeks of mean corrected age), poor foveal distinction was found as well (visible in 42.8% of cases with 49 weeks of mean corrected age). We found a positive correlation between visibility of posterior pole structures and increasing age. Migration of fluorophores following the retinal vascularization was seen, expanding in an eccentric pattern starting from the optic nerve.

Conclusions : It is possible to obtain and describe FAF patterns using ultra-widefield images in infants. FAF increases with age. Different hypoautofluorescent structures become visible throughout the first weeks/months.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Right eye. Male patient born at 26 weeks of gestation, with 860 grams of weight. He was 51 weeks of corrected age at evaluation. FAF image: hyperfluorescence in a radial fashion surrounding the optic nerve, peripapillary vessels are easily delineated.

 

Right eye. Male born at 26 weeks of gestation weighting 940 grams. He was 54 weeks of corrected age at evaluation. FAF image: hyperautofluorescence through all the retina mainly at the posterior pole, no normal hypoautofluroescence in the macular area is seen. Vessels can be identified easily due to contrast between hyperautofluorescent structures/vessels.