Blue-light fundus autofluorescence imaging of pigment epithelial detachments

Abstract

Background Pigment epithelial detachments (PEDs) occur in association with various chorioretinal diseases. With respect to the broad clinical spectrum of PEDs we describe fundus autofluorescence (FAF) characteristics of PEDs. Methods Ninety-three eyes of 66 patients (mean age 71.9 ± 11.1) with uni- or bilateral PED ( ≥ 350 µm) were included in a retrospective cross-sectional study. PEDs were secondary to age-related macular degeneration (n = 79), central serous chorioretinopathy (n = 7), polypoidal choroidal vasculopathy (n = 2), pattern dystrophy (n = 3) or idiopathic PED (n = 2). FAF images were recorded using confocal scanning laser ophthalmoscopy (488 nm excitation wavelength, detection of emission >500 nm). Diagnosis of PED was confirmed using spectral-domain optical coherence tomography. A qualitative FAF grading system was established, and grading was performed by two independent readers. Results PEDs showed highly variable characteristics on FAF imaging. FAF within the area of PED was found to be irregular/granular (n = 59, 63.4%), increased (n = 28, 30.1%), decreased (n = 3, 3.2 %), or normal (n = 3, 3.2%). Accompanying FAF changes included condensation of macular pigment (n = 67, 72.0%), focally increased FAF at the PED apex (n = 14, 15.1%) or elsewhere (n = 52, 55.9%), focally decreased FAF (n = 23, 24.7%), a cartwheel-like pattern (n = 10, 10.8%), a doughnut sign (n = 6, 6.5%), and a halo of decreased FAF encircling the PED (completely n = 20, 21.5% or incompletely n = 20, 21.5%). Conclusions PEDs show a variety of abnormal patterns on FAF imaging. These changes in FAF signals may be secondary to morphological and metabolic alterations within corresponding retinal layers and do not necessarily correspond with the underlying PED subtype or a specific pathology.

Integrating Machine Learning and Traditional Survival Analysis to Identify Key Predictors of Foveal Involvement in Geographic Atrophy

“…This apparent contradiction may be explained by the presence of focal lipofuscin accumulations, often seen alongside drusenoid pigment epithelial detachments or acquired vitelliform lesions, both of which are prone to evolve into macular atrophy following lesion reabsorbtion. 26 , 27 It is important to note, yet, that only a small fraction (5%) of the eyes in our study exhibited a focal FAF pattern, which could limit the statistical power of these observations.…”

Impact of lens autofluorescence and opacification on retinal imaging

“…Precise cut-off values for lenticular AF and opacification are critical for selecting candidate patients in clinical trials. Image quality requirements depend on the analysis performed (eg, qualitative analysis vs quantitative assessment of (quantitative) AF images) 33–35. Our advice for AF analysis would be a MOS/CNN MOS of 7 and above (figure 2).…”