Blue Light And Near Infrared Fundus Autofluorescence In Best Vitelliform Macular Dystrophy

Purpose To investigate the characteristics of blue light (BL) and near infrared (NIR) fundus autofluorescence (FAF) in patients affected by Best vitelliform macular dystrophy (BVMD). Methods Clinical data (visual acuity -VA-, red free and colour photos, BL and NIR FAF) of 13 patients (25 eyes) with BVMD were retrospectively reviewed. The diagnosis of BVMD was based on the presence of a positive family history and an abnormally low to absent electrooculogram light rise (Arden ratio <1.5); 5 patients had also genetic analysis. BL FAF was obtained by using argon laser light (488 nm) to excite and a band-pass filter with a cutoff at 500 nm to detect. NIR FAF was recorded with a diode laser light (787 nm) to excite and a band-pass filter with a cutoff at 800 nm to detect. For the purpose of the current study, BVMD lesions were staged essentially according to the clinical classification proposed by Gass (i.e. subclinical [SC], vitelliform [V], pseudohypopyon [PH], vitelliruptive [VE] and Atrophic [A] stage). Results All clinical stages of BVMD were found in the study population. Several different patterns for both BL and NIR FAF could be identified: normal autofluorescence, hyperautofluorescence, hypoautofluorescence, focal hypoautofluorescence, gravitational hyperautofluorescence, patchy and spoke-like hyperautofluorescence. A statistically significant difference in visual acuity was found not only in eyes with different stages of the disease but also in eyes with different FAF patterns. Particularly VA was significantly different in: SC vs A stage (p=0.007); V vs A stage (p=0.02); normal vs hypoautofluorescence at BL FAF (p=0.02); normal vs patchy autofluorescence at NIR FAF (p=0.04). Conclusions This preliminary investigation shows that BL and NIR FAF have a proteiform appearance in BVMD: some FAF patterns may correlate with VA.