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

286 Richard F. Spaide

Fig. 17.17  a,b The right eye of a 26-year-old architect had an optic nerve pit at the border of an optic disc much larger than the fellow eye. The optic nerve pit was associated with a macular detachment containing yellow material. The visual acuity was 20/60. c,d The yellow material was hyperautofluorescent. e The outer surface of the detachment had a shaggy accumulation of material (From K, Visaetsilpanonta S, Yannuzzi LA, Spaide RF. Autofluorescence imaging of optic pit maculopathy. Retina. 2007;27:116–119)

288 Richard F. Spaide

Fig. 17.18  The patient in Fig. 17.16 underwent an outer retinal fenestration [76]. a When examined 2 months later the detachment had resolved, although there was still some inner retinal edema. Note the decrease in yellow material with a corresponding decrease in the associated hyperautofluorescence (b). c The optical coherence tomogram shows cystoid changes in the inner retina, but a flattening of the detachment

290 Richard F. Spaide

Fig. 17.19  a This patient had vitreomacular traction syndrome. b An optical coherence tomographic picture taken after vitrectomy shows a collection of subretinal fluid with material on the outer surface of the retina. c One year later the patient had a yellow spot in the center of the macula in the right eye. d The left eye had no similar abnormality. e Autofluorescence photography shows a hyperautofluorescent area corresponding to the accumulation seen in image c. f The optical coherence tomographic picture shows a mound of material under the central fovea. The patient was examined 1 year later, and there was no change in the yellow hyperautofluorescent spot in the right eye. Note that if the patient had been examined without a history, the appearance of the right macula might have suggested the diagnosis of adult-onset foveomacular vitelliform dystrophy

292 Richard F. Spaide

Fig. 17.20a–c  This patient had a small yellow dot in the center of the fovea consistent with a stage 1 macular hole of Gass. The autofluorescence photograph shows a hyperautofluorescent spot. The optical coherence tomographic picture photograph shows increased accumulation on the outer surface of the foveola (c). In this case, the stage 1 macular hole appearance actually corresponded to what Gass proposed before the existence of optical coherence tomography, which is not true for many patients with prehole states. The origin of the observed yellow color may be from the accumulated material on the outer surface of the retina

294 Richard F. Spaide

Fig. 17.21  a This patient had prominent vitreomacular traction with a small amount of hemorrhage above the central macular detachment. b Optical coherence tomography shows a dramatic picture of traction and elevation of the central macula. c The patient underwent vitrectomy and membrane peeling. The detachment partially flattened, leaving a collection of yellow material superior to the fovea when examined 1 week after surgery. Note that the yellow dots on the outer surface of the retina appear much the same as those seen in central serous chorioretinopathy. d The optical coherence tomographic scan shows persistent subretinal fluid and a hyperreflective thickening at the outer retina corresponding to the yellow material. e The autofluorescence photograph taken on the same day shows that both the yellow material and the punctate dots are hyperautofluorescent. f One month later there was partial reabsorption of the yellow material superiorly. g Four months later there was partial resolution of the subretinal fluid. The yellow dots are in a different position than in image c, and the dots were hyperautofluorescent