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¹İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Göz Hastalıkları A.D., İstanbul, Doç. Dr.
²İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Göz Hastalıkları A.D., İstanbul, Asist. Dr. Purpose: To evaluate the fundus autofluorescence (FAF) features of choroidal melanocytic lesions and secondary changes [drusen, orange pigment, fibrous metaplasia, retinal pigment epithelium (RPE) atrophy, and subretinal fluid] overlying these lesions.
Materials and Methods: A scanning confocal laser ophthalmoscopy system (HRA, Heidelberg Retina Angiograph, Heidelberg Engineering, Dossenheim, Germany) was used for FAF imaging. Between January and May 2008, 16 patients who underwent FAF imaging with the diagnosis of a choroidal melanocytic lesion were included in the study.
Results: Of these 16 patients, choroidal nevus was detected in 11, choroidal melanoma in three, and congenital hypertrophy of the RPE and optic nerve head melanocytoma in one each. Of the 11 patients with choroidal nevus, overlying secondary changes (drusen in four, orange pigment in four) were detected in eight. In the four patients with orange pigment, radioactive plaque treatment was suggested in three with the diagnosis of a small choroidal melanoma. Iso-autofluorescence was seen in three lesions without any overlying secondary changes. In three patients with choroidal melanoma, the areas with RPE atrophy were hypofluorescent and the areas with orange pigments and subretinal fluid were hyperfluorescent. Optic nerve melanocytoma was hypofluorescent and the lacunae on congenital RPE hypertrophy were hyperfluorescent.
Conclusion: FAF allows noninvasive imaging of RPE. It is a valuable tool in the differentiation of choroidal melanocytic lesions. FAF especially gives additional important information in the differential diagnosis of some suspicious choroidal nevi with presumed small choroidal melanomas. Keywords : Choroid, fundus autofluorescence, retinal pigment epithelium, orange pigment, tumor