FUNDUS AUTOFLUORESCENCE IN PATIENTS WITH MACULAR HOLES IMAGED WITH A LASER-SCANNING OPHTHALMOSCOPE

Aim-To demonstrate the usefulness of a recently developed technique of imaging fundus autofluorescence and to compare it with the results of fluorescein angiography in the diagnosis and staging of macular holes . Methods-The intensity and distribution of fundus autofluorescence wa s studied in 51 patients with idiopathic macular holes and pseudoholes using a confocal laser scanning ophthalmoscope (cLSO) and the images were compared with those obtained by fundus fluorescein angiography. R esults-Autofluorescence imaging demonstrated bright fluorescence of ma cular holes with appearance similar to that obtained by fluorescein an giography In contrast macular pseuodoholes showed no such autofluoresc ence. The attached operculum in stage 2 macular holes and the preretin al operculum in stage 3 macular holes showed focal decreased autofluor escence. The associated retinal elevation and the cuff of subretinal f luid were less fluorescent compared with the background autofluorescen ce of the normal fellow eyes. Following successful surgical treatment the autofluorescence of the macular holes was no longer visible. Concl usion-Autofluorescence imaging with the cLSO makes the assessment of m acular holes possible with an accuracy comparable with that of fluores cein angiography. Being non-invasive and rapid, autofluorescence imagi ng may become a useful alternative to fluorescein angiography in the a ssessment and the differential diagnosis of full thickness macular hol es.