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

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Fig. 18.1  Top row: Red-free reflectance and fundus autofluorescence (FAF) images of the right eye of a patient with macular hole. FAF imaging shows distinct changes with a bright signal inside the hole and a surrounding ring of decreased intensity. Bottom row: Optical coherence tomography and schematic drawing. The edges of the hole are usually upturned, like a drawbridge. Hence, the excitation light has a larger distance to travel through the neurosensory retina to reach the retinal pigment epithelium and backward again (arrows). This may cause more absorption by luteal pigment and could explain the decreased autofluorescence at the edge of the hole

Fig. 18.2  Fundus photograph, optical coherence tomography (OCT), and fundus autofluorescence (FAF) images of a 24-year-old man. He had poor vision from a young age, without progressive deterioration. At presentation, visual acuities were 6/18 in both eyes. Electrophysiology showed misrouting at the chiasm, suggesting ocular albinism, while no features of cutaneous albinism were visible. Horizontal OCT scanning discloses continuous retinal layers through the central retina. In addition to the absence of the foveal avascular zone, FAF imaging shows normal background levels and no decreased intensity (lack of macula pigment) in the center of the macula. Images courtesy of Declan Flanagan, consultant ophthalmic surgeon, Moorfields Eye Hospital, London

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Fig. 18.3  Reflectance, optical coherence tomography (OCT), fundus autofluorescence (FAF), and late-phase fluorescein angiography images of a 51-year-old woman with chloroquine maculopathy. FAF imaging shows a mottled pattern of increased and decreased intensities in the pericentral retina and further levels of increased intensity toward eccentricity. In the fovea itself, a cystoid macula edema is present in both eyes, showing irregular levels of increased autofluorescence

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Fig. 18.4  Top row: Bilateral disc drusen characterized by markedly increased fundus autofluorescence (FAF) signals in the central portion of the optic disc. Large retinal arterial and venous vessels anterior to the drusen mask the FAF signal. Middle and bottom rows: Unilateral disc drusen in the left eye. The nerve fiber analysis demonstrates marked reduction in nerve fiber layer thickness of the left eye compared with the uninvolved right eye

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Fig. 18.5  Pseudoxanthoma elasticum. a A montage autofluorescence photograph shows extensive atrophy of the macula and radiating angioid streaks (arrow) with associated lobular areas of retinal pigment epithelium (RPE) atrophy (arrowhead) that resemble pearls on a string. Drusen of the optic nerve are hyperautofluorescent (small arrow). b A montage autofluorescence photograph shows extensive scarring in the macula from choroidal neovascularization, with lobular areas of atrophy (small arrowhead) and diffuse areas of poorly defined RPE atrophy (large arrowhead)

Fig. 18.6  a This patient with uterine cancer had a rapid profound loss of vision in both eyes secondary to bilateral diffuse uveal melanocytic proliferation. She had a myriad of round areas of what had been called retinal pigment epithelial atrophy in the past. b Fluorescein angiography showed multiple transmission defects, and the autofluorescence photograph showed a loss of the normal fundus autofluorescence in these regions of transmission defect. Optical coherence tomography revealed that the nummular areas had no cellular elements at the level of the retinal pigment epithelium (From Wu S, Slakter JS, Shields JA, Spaide RF (2005) Cancer-associated nummular loss of the pigment epithelium. Am J Ophthalmol 139:933–935)