Diagnosis of Stargardt's disease by the combination of SD-OCT and FFA

Abstract

Objective To investigate the significance of combined SD-OCT and FFA in the diag nosis of Stargardt's disease.Methods Retrospective case series study.The SD-OCT and FFA images of 21 patients (42 eyes) with Stargardt's disease were collected and thereafter summarized the characteristics.Results The Stargardt's disease was known as bilateral ocular disorder with variable features at different stages.At the early stage,it presented as macula pigment disturbance and yellow flecks on biomicroscopy,mottled transmitted fluorescence on FFA,and the disruption and defect of IS/OS with normal choroidal appearance on SD-OCT.At the medium stage,Stargardt's disease was observed as mild oval-like atrophy lesion encircled by yellow dots by ophthalmoscope,mottled window defect at macula on FFA,and defect or absence of IS/OS,outer nuclear layer and outer plexiform layer signals on SD-OCT.While at the late stage,it was observed with golden reflection and oval atrophy lesion circled by yellow flecks by ophthalmoscope,target-like and dot-like window defect on FFA,and the disappearance of inner nuclear layer,outer plexiform layer and IS/OS layer,thinning of RPE layer and enhancement of choroid on SD-OCT,which indicated the atrophy of macular layers.Conclusions The combination of SD-OCT and FFA can diagnose Stargardt's disease precisely,and what's more,SD-OCT is of great importance in evaluating the severity of the disease. Key words: Spectral-domain optical coherence tomography; Fundus fluorescence angiography; Stargardt's disease