Original article
Near-infrared and Short-wavelength Autofluorescence in Resolved Central Serous Chorioretinopathy: Association With Outer Retinal Layer Abnormalities

https://doi.org/10.1016/j.ajo.2013.02.016Get rights and content

Purpose

To evaluate the correlation between changes in fundus autofluorescence (AF) measured using 2 different sources (near-infrared fundus autofluorescence from melanin and short-wavelength fundus autofluorescence from lipofuscin) with changes in spectral-domain optical coherence tomography (SD OCT) and fluorescein angiography in resolved central serous chorioretinopathy (CSC).

Design

Retrospective, observational case study.

Methods

A total of 91 eyes from 86 patients with a history of resolved CSC and abnormal AF imaging findings were included. In addition to AF, patients were assessed by means of SD OCT and fluorescein angiography. Outer retinal layer alterations in OCT images and abnormalities in fluorescein angiography were analyzed and correlated with the corresponding AF data.

Results

All eyes with abnormal near-infrared AF showed a hyperfluorescent angiography window defect in the corresponding area. There was a significant association between the OCT and short-wavelength AF findings. An abnormal short-wavelength AF signal was significantly associated with loss of the ellipsoid portion of the inner segments (EPIS, previously known as the junction between the inner and outer segments of the photoreceptors) on SD OCT (χ2 test; P < .0001). Near-infrared AF could not predict the status of EPIS without the short-wavelength AF image.

Conclusions

Outer retinal layer changes in OCT images can be predicted by analyzing both short-wavelength AF and near-infrared AF images. Abnormal changes in the short-wavelength AF image were predictive of EPIS damage.

Section snippets

Methods

Approval for this study was obtained from the Korea University Medical Center Institutional Review Board, Seoul, South Korea. All research protocols and data collection complied with the Declaration of Helsinki.

Results

Ninety-one eyes of 86 patients were analyzed. The average patient age was 41.55 ± 4.97 years, and the male-to-female ratio was 73 (84.9%) to 13 (15.1%). The mean logMAR best-corrected visual acuity was 0.25 ± 0.39. Eyes were categorized into 3 different groups according to the results of near-infrared AF, short-wavelength AF, SD OCT, and fluorescein angiography (Table 1).

Eyes with abnormalities on either near-infrared AF or short-wavelength AF were included. Near-infrared AF abnormalities were

Discussion

In the present study, patients with a history of resolved CSC and abnormal near-infrared or short-wavelength AF results were assessed by means of SD OCT and fluorescein angiography. Interestingly, abnormal near-infrared AF lesions and corresponding window defects in fluorescein angiography were detected in the entire group, but short-wavelength AF abnormalities were present only in a subset of eyes (53/91 eyes). This implies that near-infrared AF is more sensitive than short-wavelength AF at

Sang-Kyoon Kim, MD, is a clinical instructor in the Department of Ophthalmology at Korea University College of Medicine. Dr Kim graduated from Korea University Medical School in 2004, and completed his ophthalmology residency there in 2009. He is currently pursuing a retinal fellowship. His special interests are disorders of the retina and uveitis.

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    Sang-Kyoon Kim, MD, is a clinical instructor in the Department of Ophthalmology at Korea University College of Medicine. Dr Kim graduated from Korea University Medical School in 2004, and completed his ophthalmology residency there in 2009. He is currently pursuing a retinal fellowship. His special interests are disorders of the retina and uveitis.

    Seong-Woo Kim, MD, PhD, is an associate professor in the Department of Ophthalmology of Korea University College of Medicine. Dr Kim graduated from Korea University Medical School, where he completed his ophthalmology residency and retinal fellowship. His recent clinical and research interests include the correlation of fundus autofluorescence with visual function and combining vitrectomy with cataract and glaucoma valve surgery.

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