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The value of retinal imaging with infrared scanning laser ophthalmoscopy in patients with stargardt disease
Journal article   Open access   Peer reviewed

The value of retinal imaging with infrared scanning laser ophthalmoscopy in patients with stargardt disease

Robert Chun, Gerald A Fishman, Frederick T Collison, Edwin M Stone, Jana Zernant and Rando Allikmets
Retina (Philadelphia, Pa.), Vol.34(7), pp.1391-1399
07/2014
DOI: 10.1097/IAE.0000000000000070
PMCID: PMC4098760
PMID: 24317291
url
http://doi.org/10.1097/IAE.0000000000000070View
Open Access

Abstract

To demonstrate the value of infrared scanning laser ophthalmoscopy (SLO) for determining structural retinal and choroidal changes in patients with Stargardt disease and its comparison to findings on short-wavelength fundus autofluorescence (SW-AF) imaging, spectral-domain optical coherence tomography, and microperimetry measurements. Forty-four eyes of 22 patients with Stargardt disease were studied using infrared-SLO, spectral-domain optical coherence tomography, macular microperimetry, SW-AF, electroretinography, and fundus photography. Although SW-AF imaging outlined the regions of retinal pigment epithelial (RPE) atrophy (hypofluorescence) and enhanced the visibility of more funduscopically apparent flecks (hyperfluorescence), infrared-SLO imaging outlined the regions of choroidal, and RPE, atrophic changes. Degenerative changes in photoreceptor and RPE cell layers, evident on spectral-domain optical coherence tomography imaging, were associated with either hyporeflective or hyperreflective images on infrared-SLO imaging, depending on whether both RPE and choroidal atrophy (hyperreflectance) or solely RPE atrophy (hyporeflectance) was present. Threshold elevations on microperimetry testing corresponded to both RPE and choroidal atrophy on infrared-SLO imaging and RPE atrophy on SW-AF. Although SW-AF identifies regions of RPE atrophy, infrared-SLO also identifies the involvement of the choroid that has important implications for the potential improvement in visual function from treatment. Thus, infrared-SLO imaging offers an additional advantage beyond that obtained with SW-AF.
Electroretinography Optical Imaging Macular Degeneration - physiopathology Tomography, Optical Coherence Humans Middle Aged Male Macular Degeneration - diagnosis Young Adult Infrared Rays Adult Female Visual Field Tests Ophthalmoscopy - methods Choroid - pathology Retina - pathology Visual Acuity - physiology

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