Photobleaching by Spectralis Fixation Target

IMPORTANCE The aim of this study is to determine whether the cross-shaped fixation target in a spectral-domain optical coherence tomography instrument (Spectralis; Heidelberg Engineering) could produce a cross-shaped increase fundus autofluorescence artifact on subsequent imaging. OBSERVATIONS Thirty eyes of 15 healthy volunteers (8 women and 7 men; mean [SD] age 24 [3] years) were included in the study, which was conducted between October 2015 and December 2015. In all eyes, a cross-shaped increase in macular autofluorescence with variable intensity occurred after Spectralis spectral-domain optical coherence tomography acquisition. This peculiar pattern was also detected on confocal scanning laser ophthalmoscope infrared reflectance and MultiColor imaging. Interestingly, no changes in macular fundus autofluorescence pattern were evident after optical coherence tomography acquisition with either Cirrus HD-OCT 5000 or RTVue XR Avanti. CONCLUSIONS AND RELEVANCE In an era characterized by extensive use of optical coherence tomography examination in clinical practice, the potential deleterious effects related to photopigments consumption by Spectralis optical coherence tomography fixation point deserve further investigation.