Ординатура / Офтальмология / Английские материалы / Atlas of Fundus Autofluorescence Imaging_Holz, Schmitz-Valckenberg, Spaide, Bird_2007

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Fig. 9.12  Cone and cone-rod dystrophy (GCAP-1). Fundus autofluorescence (FAF) images of patients with mutations in the guanylate cyclase activator 1A gene encoding guanylate cyclase activating protein-1 [5]. Top row: A 41-year-old woman with abnormal generalised cone dysfunction on electrophysiology. FAF images show symmetrically bilateral bull’s-eye-shaped lesions with decreased intensity and a surrounding ring of increased autofluorescence. This lesion was hardly visible on fundus photography. Middle row: Only subtle autofluorescence changes with loss of macula pigment absorption and marked increased autofluorescence are present in early stages. Bottom row: In later stages, areas of focally decreased intensity or—even later—of markedly decreased autofluorescence due to the development of atrophy are observed. Note that the ring of increased signal surrounding the lesion is visible in advanced stages as well

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Fig. 9.13  Cone dystrophy. Fundus photographs and fundus autofluorescence (FAF) images of a 40-year-old man with visual acuities of 6/60 in the right eye and 1/60 in the left. He had noticed visual problems 4 years previously. Electrodiagnostic testing revealed generalized cone dysfunction and supernormal rod function. Fundus photography shows symmetrically bilateral foveal bull’s-eye lesions. The FAF characteristics are unusual with mainly levels of increased intensity [5]. There are also small areas with decreased intensity inside the lesion, indicating development of retinal pigment epithelium atrophy. These areas with decreased signal are more prominent in the left eye, which corresponds with visual acuity measurement. One year later (bottom row), FAF imaging shows only subtle changes over time

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Fig. 9.14  Retinitis pigmentosa. Fundus photographs, fundus autofluorescence (FAF) images, and near-infrared reflectance images of a 22-year-old woman with retinitis pigmentosa 18. Visual acuities were 6/6 in the right eye and 6/18 in the left. Pattern and Ganzfeld electroretinograms were both abnormal, whereas rod exceeded cone dysfunction. There are no obvious macular changes on the fundus photograph or reflectance image. By contrast, FAF imaging shows a typical ring of increased intensity (see also Chap. 9)

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Fig. 9.15  Retinitis pigmentosa. Top and middle rows: Fundus autofluorescence (FAF) images of both eyes of a 51-year-old man with a presumably autosomalrecessive inheritance pattern. In addition to the ring of increased FAF, severe retinal pigment epithelium changes can be visualized in the peripheral retina with levels of increased and decreased autofluorescence [21]. Bottom row: Patient with sector retinitis pigmentosa. FAF imaging clearly shows the involved areas in the inferior retina. The ring of increased intensity appears to be interrupted at the superior macula

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Fig. 9.16  Retinitis pigmentosa, Usher syndrome. Fundus photographs and fundus autofluorescence (FAF) images of two patients with Usher syndrome type 2. Central visual acuity was preserved. Visual field testing showed extensive constriction corresponding to the central area of normal-appearing FAF intensity. Note that the extension and presence of morphological abnormalities can be much better visualized with FAF imaging