Distinct Characteristics of Inferonasal Fundus Autofluorescence Patterns in Stargardt Disease and Retinitis Pigmentosa

作者：Duncker Tobias; Lee Winston; Tsang Stephen H; Greenberg Jonathan P; Zernant Jana; Allikmets Rando; Sparrow Janet R^*

来源：Investigative Ophthalmology & Visual Science, 2013, 54(10): 6820-6826.

DOI：10.1167/iovs.13-12895

• ABCA4
• fundus autofluorescence
• lipofuscin
• melanin
• optic fissure
• retinal pigment epithelium
• retinitis pigmentosa
• scanning laser ophthalmoscope
• recessive Stargardt disease

PURPOSE. To report distinct characteristics of fundus autofluorescence (AF) patterns inferior to the optic disc in recessive Stargardt disease (STGD1) and retinitis pigmentosa (RP).
METHODS. Short-wavelength (SW) and near-infrared (NIR) AF images were acquired from patients with STGD1 and RP. In SW-and NIR-AF images of STGD1 patients, gray levels (GL) on both sides of the demarcation line were measured.
RESULTS. In STGD1, a demarcation line, which has been assigned to the closed optic fissure, was visible on SW-AF and NIR-AF inferior to the optic disc. In healthy subjects, this demarcation line is only visible by SW-AF. At 208 inferior to the disc center, AF levels on the nasal side were 25% (+/-11%) lower than on the temporal side in SW-AF images and 18% (+/-11%) lower in NIR-AF images. For both STGD1 and RP, the inferonasal quadrant exhibited distinct SW-and NIR-AF patterns compared with other fundus areas. Disease-related AF changes, such as flecks, appeared to respect the demarcation line as a boundary.
CONCLUSIONS. Disease-related AF patterns originating in RPE in STGD1 and RP appear to respect the demarcation line in the inferonasal quadrant of the fundus as a border. The visibility of the inferonasal demarcation line by NIR-AF in STGD1 but not in healthy eyes may indicate that increased levels of RPE lipofuscin modulate the melanin-related NIR-AF signal. This feature of NIR-AF images may aid in the diagnosis of STGD1 patients.

• 出版日期2013-10