Acute retinal necrosis other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

Other imaging findings that may be helpful in the diagonsis of acute retinal necrosis include fundus autofluorescence, fluorescein angiography, and optical coherence tomography.

Other Imaging Findings

Fundus Autofluorescence

Fundus autofluorescence (FAF) is an imaging technique that examines fluorophores in the neurosensory retina and the retinal pigment epithelium, presenting with the following findings indicative of acute retinal necrosis:[1]

  • Hypoautofluorescence in the retina, in conjunction with hyperfluorescent borders, is indicative of acute retinal necrosis and atrophy of the retinal pigment epithelium.[2]
    • Posterior extension of the hyperfluorescent borders may be indicative of spreading inflammation and acute retinal necrosis.
    • Hyperfluorescence may also be indicative of reduced ability to block fluorophores into the retina due to damage and degradation.[3]
  • FAF is advantageous to color photos due to the ability to more starkly contrast lesions with unaffected retinal tissue.

Fluorescein Angiography

Fluorescein angiographic images may indicate acute retinal necrosis by displaying retinal vasculature and potential retinal hemorrhages, as well as white-yellow necrotic lesions.[4][5]

  • Fluorscein angiography can reveal optic nerve head leakage caused by intraocular inflammation from the pathogent responsible for ARN.[6]
  • Imaging may reveal occlusive vasculopathy and periarterial vascular sheathing.

Optical Coherence Tomography

Optical coherence tomography (OCT) imaging may indicate acute retinal necrosis through the following:[7]

References

  1. Delori FC, Dorey CK, Staurenghi G, Arend O, Goger DG, Weiter JJ (1995). "In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics". Invest. Ophthalmol. Vis. Sci. 36 (3): 718–29. PMID 7890502.
  2. Freund, K. Bailey; Mrejen, Sarah; Jung, Jesse; Yannuzzi, Lawrence A.; Boon, Camiel J. F. (2013). "Increased Fundus Autofluorescence Related to Outer Retinal Disruption". JAMA Ophthalmology. 131 (12): 1645. doi:10.1001/jamaophthalmol.2013.5030. ISSN 2168-6165.
  3. Ward TS, Reddy AK (2015). "Fundus autofluorescence in the diagnosis and monitoring of acute retinal necrosis". J Ophthalmic Inflamm Infect. 5: 19. doi:10.1186/s12348-015-0042-3. PMC 4477008. PMID 26120371.
  4. Takei H, Ohno-Matsui K, Hayano M, Mochizuki M (2002). "Indocyanine green angiographic findings in acute retinal necrosis". Jpn. J. Ophthalmol. 46 (3): 330–5. PMID 12063045.
  5. "Fluorescein angiography: MedlinePlus Medical Encyclopedia".
  6. Abu El-Asrar AM, Herbort CP, Tabbara KF (2009). "Differential diagnosis of retinal vasculitis". Middle East Afr J Ophthalmol. 16 (4): 202–18. doi:10.4103/0974-9233.58423. PMC 2855661. PMID 20404987.
  7. Suzuki J, Goto H, Minoda H, Iwasaki T, Sakai J, Usui M (2006). "Analysis of retinal findings of acute retinal necrosis using optical coherence tomography". Ocul. Immunol. Inflamm. 14 (3): 165–70. doi:10.1080/09273940600672198. PMID 16766400.

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