Artikel
Fundus autofluorescence in children and teenagers with hereditary retinal diseases
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Autoren
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B. K. Wabbels
- University of Regensburg, Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg
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K. Paunescu
- University of Regensburg, Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg
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A. Demmler
- University of Regensburg, Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg
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B. Lorenz
- University of Regensburg, Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg
| Veröffentlicht: | 22. September 2004 |
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Gliederung
Text
Objective
In adults, evaluation of fundus autofluorescence (AF) plays an important role in the differential diagnosis of retinal diseases. The aim of this study was to evaluate the feasibility of recording AF in children and teenagers and to characterise typical AF findings of various hereditary retinal diseases.
Methods
Fifty patients aged 2 to 18 years with hereditary retinal diseases were evaluated using the HRA (Heidelberg Retina Angiograph). To enhance the AF signal, a mean of up to 16 single images was calculated.
Results
In many children as young as 5 years of age and some 2-year-old children good AF images could be obtained. To achieve high quality images, larger image series (about 50 single images) were taken and appropriate single images to calculate the mean were chosen manually. Characteristically, M. Stargardt shows a central oval area of reduced AF, often surrounded by a more irregular AF. In patients with M. Best, a central round structure with regular or irregular intense AF is visualised, carriers have normal AF. In early-onset severe retinal dystrophy (EOSRD) with RPE65-mutations AF is completely absent (Lorenz et al., Ophthalmology 2004, in press), whereas in other forms of Leber congenital amaurosis, AF is about normal. In many patients with rod-cone-dystrophies, a central "rod ring" of increased AF is present. Some patients with X-linked retinoschisis show central radial structures of increased AF.
Conclusions
Fundus autofluorescence may visualise a disease specific distribution of lipofuscin in the retinal pigment epithelium, often not (yet) visible on ophthalmoscopy. AF images can be used in children to differentiate hereditary retinal diseases and to facilitate follow-up controls. In many cases, four single images are sufficient to analyse the AF pattern.
DFG Lo 457/3- 1-3, DFG Lo 457/5-1,2
