FUNDUS AUTOFLUORESCENCE IN RUBELLA RETINOPATHY: Correlation With Photoreceptor Structure and Function. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Bukowska, Danuta M.; Wan, Sue Ling; Chew, Avenell L.; Chelva, Enid; Tang, Ivy; Mackey, David A.; Chen, Fred K.
• Is Part Of: Retina. Volume 37:Issue 1(2017:Jan.)
• Publication Date: 2017-01
• Subjects: adaptive optics -- autofluorescence -- congenital rubella syndrome -- microperimetry -- scanning laser ophthalmoscopy -- spectral domain optical coherence tomography; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000001130
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To illustrate altered fundus autofluorescence in rubella retinopathy and to investigate their relationships with photoreceptor structure and function using multimodal imaging. Methods: The authors report four cases of rubella retinopathy aged 8, 33, 42, and 50 years. All patients had dilated clinical fundus examination; wide-field color photography; blue, green, and near-infrared autofluorescence imaging and spectral domain optical coherence tomography. Two patients also underwent microperimetry and adaptive optics imaging. En face optical coherence tomography, cone mosaic, and microperimetry were coregistered with autofluorescence images. The authors explored the structure–function correlation. Results: All four patients had a "salt-and-pepper" appearance on dilated fundus examination and wide-field color photography. There were variable-sized patches of hypoautofluorescence on both blue and near-infrared excitation in all four patients. Wave-guiding cones were visible and retinal sensitivity was intact over these regions. There was no correlation between hypoautofluorescence and regions of attenuated ellipsoid and interdigitation zones. Hyperautofluorescent lesions were also noted and some of these were pseudo-vitelliform lesions. Conclusion: Patchy hypoautofluorescence on near-infrared excitation can be a feature of rubella retinopathy. This may be due to abnormal melanin production or loss of melanin within retinal pigment epithelium cells harboring persistent rubella virus infection. Preservation of the ellipsoid zone, wave-guiding cones, and retinal sensitivity within hypoautofluorescent lesions suggest that these retinal pigment epithelium changes have only mild impact on photoreceptor cell function. Abstract : The authors describe fundus autofluorescence features of four patients with rubella retinopathy. Hypoautofluorescent lesions on blue and near-infrared excitation did not correlate with attenuation of ellipsoid or interdigitation zone. There was no significant reduction in retinal sensitivity in regions with hypoautofluorescence. The authors discuss the mechanisms for autofluorescence features in rubella retinopathy.