Early Detection of Incipient Retinal Pigment Epithelium Atrophy Overlying Drusen with Fundus Autofluorescence vs. Spectral Domain Optical Coherence Tomography

Figure 3

Examples of simultaneous detection, earlier detection with FAF, and earlier detection with SD-OCT. FAF: fundus autofluorescence; RPE: retinal pigment epithelium; and SD-OCT: spectral domain optical coherence tomography. (a) Simultaneous detection (the incipient RPE atrophy was observed at the same time with both exams). In the top image (14/Dec/2010), the selected druse (yellow arrow) showed normal autofluorescence on FAF and no hypertransmission on SD-OCT. In the next visit (16/Jun/2011), incipient atrophy of the RPE by both imaging techniques was observed. (b) Earlier detection with FAF (RPE atrophy overlying drusen is detected earlier on FAF than on SD-OCT). The top image (08/Jul/2015) shows that while a marked area of absence of autofluorescence appears on FAF, no signs of RPE atrophy were detected with SD-OCT. In the bottom image (31/Jan/2017), after 18 months, signs of atrophy on SD-OCT can be observed and the area of atrophy on FAF increased in size. (c) Earlier detection with SD-OCT. In the top image (04/Nov/2010) there is SD-OCT hypertransmission (yellow arrow), but normal FAF. Seven months later (09/Jun/2011), the absence of autofluorescence was noticeable (bottom image).