PMC4189704_01
Diagnostic imaging in a 32-year-old patient with acute macular neuroretinopathy.. Notes: (A) Fundus photograph shows subtle reddish-brown discoloration superior to the fovea. (B) Fundus autofluorescence image shows multiple radial areas of hypoautofluorescence corresponding to patient's paracentral scotomata. (C) Near-infrared reflectance image highlights the hyporeflective lesions in the fovea. (D) Spectral-domain optical coherence tomography scan shows areas of attenuation of the ellipsoid portion of the inner segments nasal to the fovea (yellow arrows).
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A corresponding SD-OCT image showed disruption of the ellipsoid portion of the inner segments (Figure 4).
PMC4189704_02
Fundus photographs and corresponding autofluorescence of patient with acute posterior multifocal placoid pigment epitheliopathy.. Notes: A, C, E, and G show the right eye. B, D, F, and H show the left eye. (A and B) Active phase of acute posterior multifocal placoid pigment epitheliopathy shows bilateral cream-colored, placoid lesions with ring of hyperpigmentation in the right eye and fovea-threatening lesion in the left eye. (C and D) Following treatment with corticosteroids, hyperpigmentation of the lesions is observed in the right eye and subtle retinal pigment epithelial hyperpigmentation is seen in the left eye. (E and F) Fundus autofluorescence imaging shows hypoautofluorescence with surrounding hyperautofluorescence in the early, active phase of disease in the right foveal region and in the superotemporal macula of the left eye. (G and H) With corticosteroid therapy, the hyperautofluorescence decreases and a subtle mixture of predominantly hypoautofluorescent signal is observed in the right eye more than in the left eye.
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On dilated fundus exam, there were multiple cream-colored choroidal lesions in the right eye, which were greater in number than in the left eye (Figure 5). FAF showed hyperautofluorescent borders surrounding hypoautofluorescent lesions that corresponded to choroidal lesions (Figure 5). The hyperautofluorescent borders of the lesions on FAF became more hypoautofluorescent with interspersed zones of stippled hyperautofluorescence as the disease resolved at 10 months' follow-up (Figure 5).
Fundus photographs and fundus autofluorescence in punctate inner choroidopathy.. Notes: Fundus photographs of patient with punctate inner choroidopathy show a new active lesion in the right eye (white arrow) (A) and atrophic spots with hyperpigmentation in the left eye (B). Fundus autofluorescence imaging shows a hypoautofluorescent spot with ring of hyperautofluorescence in the area of the active lesion in the right eye (white arrow) (C) and punctate hypoautofluorescence corresponding to inactive lesions in the left eye (D).
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The active lesions became hypoautofluorescent during the convalescent phase of disease illness (Figure 6).
Fundus photograph and fundus autofluorescence imaging in multifocal choroiditis.. Notes: (A) Fundus photograph shows trace vitreous haze and multiple lesions in various stages of healing within the retinal periphery and mid-periphery. (B) Fundus autofluorescence image does not adequately capture the peripheral lesions but shows hyperautofluorescence in a petaloid distribution. (C) Higher magnification of the inset in (B) (white box) shows hyperautofluorescence in a petaloid pattern from cystoid macular edema. (D) Spectral-domain optical coherence tomography scan shows multiple intraretinal cystic spaces and outer segment irregularities leading to decreased visual acuity of 20/200.. Abbreviations: T, temporal; N, nasal.
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FAF also demonstrated hyperautofluorescence in a petaloid configuration in one patient with bilateral cystoid macular edema (Figure 7).
Fundus photographs and fundus autofluorescence in serpiginous choroiditis.. Notes: Fundus photographs show helicoid areas of chorioretinal atrophy and lesions emanating from optic disc in the right eye (A) and left eye (B). There are particularly active lesions in the right eye (white arrow). Fundus autofluorescence imaging shows areas of hyperautofluorescence (white arrow) bordering areas of mixed hypo- and hyperautofluorescence corresponding to lesions in various stages of evolution in the right eye (C). In the left eye (D), there is primarily hypoautofluorescence corresponding to areas of inactive chorioretinal atrophy. However, there are mildly hyperautofluorescent areas (yellow arrows) corresponding to healing lesions. These lesions eventually became hypoautofluorescent.
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Active borders of the serpiginous lesions coincided with hyperautofluorescence on FAF imaging (Figure 8).
Fundus photograph and fundus autofluorescence in unilateral acute idiopathic maculopathy.. Notes: (A) Fundus photograph shows active stage of unilateral acute idiopathic maculopathy with hyperpigmented macular lesion with surrounding rim of retinal pigment epithelial atrophy. (B) Fundus autofluorescence shows a complex pattern of mixed hypo- and hyperautofluorescent signal within this macular lesion.
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During the acute phase of UAIM, patients showed a stippled pattern of grayish-white coloration within the fovea, observed by clinical examination and fundus photography, which correlated with a complex mixture of hypo- and hyperautofluorescence on FAF imaging (Figure 9).