Fundus Autofluorescence in Multifocal Choroiditis and Panuveitis

PurposeTo investigate the autofluorescence findings associated with multifocal choroiditis and panuveits (MCP), a condition that has marked potential to affect the retinal pigment epithelium (RPE).DesignObservational case series.MethodsThis is a retrospective review of consecutive patients with MCP examined in a retinal referral practice. Each patient was given a comprehensive examination including fundus photographs, angiographic studies, and autofluorescence photography with an excitation filter with the bandpass wavelengths of 535 to 585 nm and a barrier filter with a bandpass of 615 to 715 nm. Integrative analysis was performed of the ocular imaging to ascertain abnormalities caused by the disease.ResultsThirty-six eyes of 18 consecutive patients were evaluated. The mean duration of symptoms was 86.2 months and the mean visual acuity was 20/50. Of the 36 eyes, 23 had choroidal neovascularization (CNV). Chorioretinal hypoautofluorescent spots ≥ 125 microns usually, but not always, had the clinically evident correlate of a punched-out scar visible by color fundus photography. Chorioretinal hypoautofluorescent spots less than 125 microns, which could number in the hundreds, typically were not visible by color fundus photography. All chorioretinal scars visible by color fundus photography were visible by autofluorescence photography. During follow-up many patients developed new clinically evident chorioretinal scars, which were presaged in earlier autofluorescence photographs. CNV had a hyperautofluorescent boundary, making it readily visible.ConclusionsPatients with MCP have much more widespread involvement of the RPE than would be suspected by other means of imaging. Autofluorescence photography supplies information about inflammatory damage and secondary CNV in a noninvasive manner.