gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Fundus autofluorescence imaging of pigment epithelial detachments

Meeting Abstract

  • corresponding author F. Roth - Department of Ophthalmology, University of Bonn
  • A. Bindewald - Department of Ophthalmology, University of Bonn
  • J. Dolar-Szcasny - Department of Ophthalmology, First Eye Hospital, Medical University of Lublin, Poland
  • G. Spital - Department of Ophthalmology, University of Münster
  • J. Mackiewicz - Department of Ophthalmology, First Eye Hospital, Medical University of Lublin, Poland
  • D. Pauleikhoff - Department of Ophthalmology, University of Münster
  • F.G. Holz - Department of Ophthalmology, University of Bonn

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 160

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Veröffentlicht: 22. September 2004

© 2004 Roth et al.
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Description of fundus autofluorescence (AF) characteristics of pigment epithelial detachments (PED).


We examined 35 patients with PED with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph, exc. 488nm, em. > 500nm). In addition standard fundus photography and optical coherence tomography (OCT 3) were performed. In 31 cases (mean age 72.4 ± 7.5 years) PEDs were associated with age-related macular degeneration (AMD) including lesions with concurrent retinal angiomatous proliferations (RAP) and polypoidal choroidal vasculopathy (PCV), 4 cases (mean age 51.2 ± 4.6 years) were secondary to idiopathic central serous chorioretinopathy (ICSC).


PEDs showed variable characteristics on AF images. The majority (23 eyes/62.2%) had a corresponding marked evenly distributed increase in AF, while in 8 eyes (21.6%) there was a decreased AF and in 6 eyes (16.2%) a normal background AF. In the group with elevated AF a higher AF intensity was associated with higher maximal vertical extension of the detached RPE in OCT measurements. However, there were large PEDs with marked prominence in the group with decreased AF signal, all of which had radial hyperpigmented lines overlying the PED. All drusenoid PEDs had an increased AF signal. Except in 4 eyes (10.8%) with a large area of increased AF surrounding the PED, 25 eyes (67.6%) showed a well-defined hypoautofluorescent halo delineating the entire border of the lesion. The width of this halo was smaller in ICSC compared to AMD eyes. In comparison with unaffected fellow eyes, the distribution of macular pigment on AF images was abnormal in all examined eyes.


Our results indicate heterogenous phenotypic variations in fundus AF associated with PEDs. AF imaging has been developed as a tool to evaluate RPE lipofuscin. Our findings suggest that other dominant fluorophores may occur in the extracellular fluid between RPE and Bruch's membrane in presence of a PED. In contrast to lipofuscin the molecular species in the subRPE fluid remain to be identified. Different AF phenotypes may reflect heterogeneity on a cellular and molecular level, and may thus be relevant for future molecular genetic analyses. Further longitudinal studies using a confocal scanning laser ophthalmoscope may increase our understanding of PEDs in various retinal diseases and may help to identify novel prognostic factors.