Fundus autofluorescence in acute idiopathic maculopathy

Abstract

Purpose: To characterize changes in fluorophore metabolism during acute idiopathic maculopathy (AIM) using autofluorescence (AF) imaging.

Methods: AF imaging was performed during the clinical course of a 38-year-old man with AIM.

Results: AF imaging initially revealed distinct hypofluorescence corresponding to a clinical pattern of retinal pigment epithelium (RPE) hypopigmentation and a window defect seen on fluorescein angiography. This hypofluorescence essentially resolved within 1 week, but adjacent hyperfluorescent features persisted over the course of resolution of the macular detachment. Six weeks later, the patient reported complete resolution of the central scotoma, and fundus examination and optical coherence tomography revealed resolution of the detachment. AF revealed mild persistent nasal hyperfluorescence, but the overall reflectance was closer in quality to that of the noninvolved retina.

Conclusion: AF features in AIM reveal an acute disruption of fluorophore metabolism that resolves fairly rapidly, consistent with the concept of AIM as a self-limited inflammatory process of the RPE.