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Steven Yeh, MD; Farzin Forooghian, MD, MS; Wai T. Wong, MD, PhD; Lisa J. Faia, MD; Catherine Cukras, MD, PhD; Julie C. Lew, MD; Keith Wroblewski, MD; Eric D. Weichel, MD; Catherine B. Meyerle, MD; Hatice Nida Sen, MD, MHSc; Emily Y. Chew, MD; Robert B. Nussenblatt, MD, MPH

Arch Ophthalmol. 2010;128(1):46-56. doi:10.1001/archophthalmol.2009.368

Objective  To characterize the fundus autofluorescence (FAF) findings in patients with white dot syndromes (WDSs).

Methods  Patients with WDSs underwent ophthalmic examination, fundus photography, fluorescein angiography, and FAF imaging. Patients were categorized as having no, minimal, or predominant foveal hypoautofluorescence. The severity of visual impairment was then correlated with the degree of foveal hypoautofluorescence.

Results  Fifty-five eyes of 28 patients with WDSs were evaluated. Visual acuities ranged from 20/12.5 to hand motions. Diagnoses included serpiginous choroidopathy (5 patients), birdshot retinochoroidopathy (10), multifocal choroiditis (8), relentless placoid chorioretinitis (1), presumed tuberculosis-associated serpiginouslike choroidopathy (1), acute posterior multifocal placoid pigment epitheliopathy (1), and acute zonal occult outer retinopathy (2). In active serpiginous choroidopathy, notable hyperautofluorescence in active disease distinguished it from the variegated FAF features of tuberculosis-associated serpiginouslike choroidopathy. The percentage of patients with visual acuity impairment of less than 20/40 differed among eyes with no, minimal, and predominant foveal hypoautofluorescence (P < .001). Patients with predominant foveal hypoautofluorescence demonstrated worse visual acuity than those with minimal or no foveal hypoautofluorescence (both P < .001).

Conclusions  Fundus autofluorescence imaging is useful in the evaluation of the WDS. Visual acuity impairment is correlated with foveal hypoautofluorescence. Further studies are needed to evaluate the precise role of FAF imaging in the WDSs.

Author Affiliations: National Eye Institute, National Institutes of Health, Bethesda, Maryland (Drs Yeh, Forooghian, Wong, Faia, Cukras, Lew, Wroblewski, Weichel, Meyerle, Sen, Chew, and Nussenblatt); and Department of Ophthalmology, Walter Reed Army Medical Center, Washington, DC (Drs Wroblewski and Weichel).

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RELATED LETTER

Foveal Hypoautofluorescence: Does It Correlate to Visual Acuity in White Dot Syndromes?—Reply
Steven Yeh, Farzin Forooghian, Wai T. Wong, H. Nida Sen, Emily Y. Chew, and Robert B. Nussenblatt
Arch Ophthalmol. 2010;128(12):1629-1630.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Foveal Hypoautofluorescence: Does It Correlate to Visual Acuity in White Dot Syndromes?
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Arch Ophthalmol 2010;128:1628-1629.
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Foveal hypoautofluorescence: does it correlate to visual acuity in white dot syndromes?--reply.
Yeh et al.
Arch Ophthalmol 2010;128:1629-1630.
FULL TEXT