Abstract
Purpose. To evaluate if paracentral hyperautofluorescence (HAF) retinal regions, which can be occasionally found and analyzed by optical coherence tomography (OCT), were related to retinal layer changes and to detect which layer was involved. Methods. This is a cross-sectional and retrospective study. 648 OCT files were revised. OCTs that showed a paracentral HAF area by using the fundus autofluorescence imaging in Heidelberg Spectralis (Heidelberg Engineering, Germany) were selected. Then retinal layer morphology was analyzed observing OCT scans and a retinal thickness was measured. Results. 31 patients were selected: 20 patients had chronic serous epitheliopathy (CSE), 8 patients had resolved central serous chorioretinopathy (CSC), and 3 patients wet age related macular degeneration (ARMD). The HAF zones corresponded to areas of thickness reduction of the external hyporeflective band. In all these areas the retinal pigment epithelium was not atrophic and the neuroepithelium was more or less dystrophic. In particular the retinal thickness was 264 um, 232 um, and 243 um in wet ARMD, CSE, and CSC, respectively; the reduction was significant (P < 0.01) compared to the same area of the other eye. Discussion. The presence of HAF imaging might be mostly due to a “window effect” rather than an accumulation of lipofuscin.
Highlights
The predominant fluorophores arising from the fundus have been shown to be located within the retinal pigment epithelium (RPE) lipofuscin (LF) [1], which derives primarily from phagocytosed photoreceptor outer segments
The aim of this study was to evaluate if paracentral hyperautofluorescence (HAF) retinal regions, which can occasionally be found by a user and analyzed by optical coherence tomography (OCT), were related to retinal layer changes and to detect which layer was involved
The predominant fluorophores arising from the fundus have been shown to be located within the RPE LP [1]
Summary
The predominant fluorophores arising from the fundus have been shown to be located within the retinal pigment epithelium (RPE) lipofuscin (LF) [1], which derives primarily from phagocytosed photoreceptor outer segments. These fluorophores most likely accumulate in RPE cells because the structures of the fluorophores are unusual and not amenable to degradation, rather than because the lysosomal enzymes are defective in these cells [2]. Fundus autofluorescence (AF) imaging is a method that allows topographic mapping of LF distribution in the retinal pigment epithelium cell monolayer as well as of other fluorophores that may occur with disease in the outer retina and the subneurosensory. At the posterior pole autofluorescence is dependent on either outer segment metabolism with an increase of LF concentration [6] or a window effect for the decrease or lack of pigment along plexiform layer which covers the physiological AF [7]
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