Autofluorescence characteristics of suspicious choroidal nevi

ArticleinOptometry (St. Louis, Mo.) 80(3):126-30 · April 2009with24 Reads
Impact Factor: 7.50 · DOI: 10.1016/j.optm.2008.07.018 · Source: PubMed

The aim of this study was to describe autofluorescence characteristics of 30 suspicious choroidal nevi. Fundus autofluorescence (FAF) images were reviewed retrospectively on 30 consecutive cases of suspicious choroidal nevi. Autofluorescence imaging was achieved using a fundus camera-based system with a barrier filter of 695 nm and excitation of 580 nm. All nevi exhibited one or more of the following characteristics: tumor thickness, basal dimension greater than 5 mm, subretinal fluid, posterior location, ophthalmic symptoms, or lipofuscin (orange pigment). Suspicious choroidal nevi were found to have specific FAF features. Orange pigment was noted in 67% of the nevi and appeared as very bright hyperfluorescent areas. Overlying retinal pigment epithelium hypertrophy and atrophy were noted in 50% and appeared darkly hypofluorescent. Subretinal fluid (17%) and drusen (17%) both appeared mildly hyperfluorescent. Orange pigment was the most hyperfluorescent FAF finding. Because the presence of orange pigment is a known risk factor for malignant transformation, the use of camera-based FAF imaging may improve our ability to identify those choroidal nevi that will transform into malignant melanoma. More long-term follow-up studies will be required to determine the exact prognostic value of our findings.

    • "Optical coherence tomography (OCT) was found more sensitive for discovery of intraretinal and subretinal fluid. Fundus autofluorescent imaging (FAF) was particularly helpful to evaluate the presence of orange pigment lipofuscin, retinal pigment epithelial disease secondary and exudative retinal detachment[14]. All patients were informed of the risks and potential benefits related to observation, radiation therapy (plaque or proton beam), surgical excision and enucleation surgery. This included discussing the potential risks associated with extrascleral extension with the 2 affected patients from the large UM group[15]. "
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  • [Show abstract] [Hide abstract] ABSTRACT: To evaluate the fundus autofluorescence (FAF) patterns in the eyes with primary intraocular lymphomas (PIOLs). A review of the medical charts of four consecutive patients (five eyes) with PIOL who had been studied by FAF. A fundus camera was used to obtain the FAF images. Optical coherence tomography was also performed. The ophthalmoscopically observed brown clumps on the surface of greasy yellowish masses beneath the retinal pigmented epithelium had a bright hyperfluorescence appearance by FAF. This FAF hyperfluorescence was completely reversed to hypofluorescence in the fluorescein angiograms. The diffuse infiltration of the cells making up the PIOL above the retinal pigmented epithelium was ophthalmoscopically observed as a retinal whitening and was hypofluorescent by FAF. These areas of hypofluorescence were also reversed to areas of hyperfluorescence in the fluorescein angiogram. Fundus autofluorescence clearly delineated the retinal pigmented epithelium atrophy, which developed after the spontaneous resolution of the PIOL as a hypoautofluorescent area. Because FAF can reveal various findings of PIOLs, it can be used to differentiate the patients with PIOL from those with ocular inflammatory diseases. Although further studies are required to determine whether these findings are characteristic to PIOL, this noninvasive method can then lead to earlier diagnosis and treatment.
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