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Authors: Lima, Luiz H. [UNIFESP]
Greenberg, Jonathan P.
Greenstein, Vivienne C.
Smith, R. Theodore
Sallum, Juliana M. F. [UNIFESP]
Thirkill, Charles
Yannuzzi, Lawrence A.
Tsang, Stephen H.
Columbia Univ
Vitreous Retina Macula Consultants New York
Manhattan Eye Ear & Throat Hosp
Universidade Federal de São Paulo (UNIFESP)
Univ Calif Davis
Keywords: autoimmune retinopathy
cancer-associated retinopathy
fundus autofluorescence
hyperautofluorescent ring
inner segment-outer segment junction
spectral-domain optical coherence tomography
Issue Date: 1-Jul-2012
Publisher: Lippincott Williams & Wilkins
Citation: Retina-the Journal of Retinal and Vitreous Diseases. Philadelphia: Lippincott Williams & Wilkins, v. 32, n. 7, p. 1385-1394, 2012.
Abstract: Purpose: To report the presence of a hyperautofluorescent ring and corresponding spectral-domain optical coherence tomography (SD-OCT) features seen in patients with autoimmune retinopathy.Methods: All eyes were evaluated by funduscopic examination, full-field electroretinography, fundus autofluorescence, and SD-OCT. Further confirmation of the diagnosis was obtained with immunoblot and immunohistochemistry testing of the patient's serum. Humphrey visual fields and microperimetry were also performed.Results: Funduscopic examination showed atrophic retinal pigment epithelium (RPE) associated with retinal artery narrowing but without pigment deposits. the scotopic and photopic full-field electroretinograms were nondetectable in three patients and showed a cone-rod pattern of dysfunction in one patient. Fundus autofluorescence revealed a hyperautofluorescent ring in the parafoveal region, and the corresponding SD-OCT demonstrated loss of the photoreceptor inner segment-outer segment junction with thinning of the outer nuclear layer from the region of the hyperautofluorescent ring toward the retinal periphery. the retinal layers were generally intact within the hyperautofluorescent ring, although the inner segment-outer segment junction was disrupted, and the outer nuclear layer and photoreceptor outer segment layer were thinned.Conclusion: This case series revealed the structure of the hyperautofluorescent ring in autoimmune retinopathy using SD-OCT. Fundus autofluorescence and SD-OCT may aid in the diagnosis of autoimmune retinopathy and may serve as a tool to monitor its progression. RETINA 32:1385-1394, 2012
ISSN: 0275-004X
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