RESUMEN

BACKGROUND AND OBJECTIVE: To investigate whether multispectral imaging (MSI) is able to obtain a noninvasive view of melanin disruption associated with age-related macular degeneration (AMD), which could support early diagnosis and potential treatment strategies. PATIENTS AND METHODS: A single retinal center, retrospective, observational, image analysis study of MSI images of 43 patients was done to determine the extent of melanin pigment exhibited in association with AMD, based on the Age-Related Eye Disease Study classification and grading scale. Corresponding fundus photos were also graded for 12 of the eyes. RESULTS: Fifty-one of 61 eyes (84%) of 43 patients with AMD were determined to have melanin disruption in their MSI images in at least the central and/or one of four inner ETDRS areas. There was a relationship between severity of disease and the degree of melanin disruption. The sensitivity of fundus photography for melanin pigment as compared to MSI was only 62.5%, with three false-negatives. CONCLUSION: A direct, noninvasive, unobstructed view of melanin disruption associated with AMD can be observed using MSI.

Asunto(s)

Coroides/metabolismo , Atrofia Geográfica/metabolismo , Melaninas/metabolismo , Imagen Multimodal , Epitelio Pigmentado de la Retina/metabolismo , Degeneración Macular Húmeda/metabolismo , Anciano , Anciano de 80 o más Años , Coroides/patología , Reacciones Falso Negativas , Femenino , Angiografía con Fluoresceína , Atrofia Geográfica/diagnóstico , Atrofia Geográfica/fisiopatología , Humanos , Masculino , Imagen Óptica , Fotograbar , Valor Predictivo de las Pruebas , Epitelio Pigmentado de la Retina/patología , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía de Coherencia Óptica , Degeneración Macular Húmeda/diagnóstico , Degeneración Macular Húmeda/fisiopatología

RESUMEN

PURPOSE: To report the use of non-invasive multi-spectral imaging of a female choroideremia (CHM) carrier with mild visual symptoms and extensive fundus mottling. OBSERVATION: This was an observational case report study. A symptomatic 42-year-old female with a history of binocular CHM presented for routine ocular examination and underwent review of her clinical and photographic records, optical coherence tomography (OCT), intravenous fluorescein angiography (IVFA) and multi-spectral imaging (MSI). Dilated fundus examination and photography revealed similar outcomes of diffuse mottling with normal looking vessels. IVFA showed large irregular and confluent patches of RPE atrophy in the peripapillary and parapapillary areas as well as the midperiphery, corresponding to the OCT findings. The entire range of MSI imaging (520-940 nm) clearly illustrated the anomalies of the fundus including retinal pigment epithelium (RPE) mottling with melanin clumping not readily seen with the other imaging modalities. MSI fundus autofluorescence (MSI-FAF) showed a spotty hypo and hyperautofluorescent appearance of the fundus, consistent with the observations seen on IVFA and OCT images. CONCLUSION AND IMPORTANCE: MSI significantly improves visualization of the retinal pigment epithelium in choroideremia. The non-invasive nature of MSI technique is a valuable tool in monitoring the effect of retinal and choroidal presentation in patients with CHM.