title: Fundus autofluorescence changes in cytomegalovirus retinitis.
abstract: OBJECTIVE
  The purpose of this study was to describe fundus autofluorescence imaging features of cytomegalovirus (CMV) retinitis and to correlate fundus autofluorescence features with clinical activity.
  
  
  METHODS
  A retrospective case series was undertaken to evaluate nine eyes of six patients with active CMV retinitis. Patients were evaluated with a comprehensive ophthalmic examination, fundus autofluorescence imaging, and fundus photography. Oral valganciclovir, intravitreal ganciclovir, intravitreal foscarnet, or an ganciclovir implant was administered as clinically indicated.
  
  
  RESULTS
  In all nine eyes with active CMV retinitis, a hyperautofluorescent signal on fundus autofluorescence imaging was correlated spatially with the border of advancing CMV retinitis. Stippled areas of alternating hyperautofluorescence and hypoautofluorescence were observed in regions of retinal pigment epithelium atrophy from prior CMV retinitis. In three eyes with subtle CMV reactivation, a hyperautofluorescent border was helpful in the detection and localization of active CMV retinitis. In another patient, diffuse, punctate hyperautofluorescence after intravitreal ganciclovir and foscarnet was a concern for medication-related toxicity.
  
  
  CONCLUSIONS
  Fundus autofluorescence imaging was valuable in highlighting areas of active CMV retinitis in all patients in this series, including two patients with subtle clinical features. Fundus autofluorescence may be useful as an adjunctive imaging modality for the detection of CMV activity and aid in our understanding of the structural changes during episodes of CMV retinitis.
authors.affiliation: National Eye Institute/National Institutes of Health, Bethesda, MD, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Yeh
authors.forename: Farzin
authors.initials: F
authors.lastname: Forooghian
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Faia
authors.forename: Eric D
authors.initials: ED
authors.lastname: Weichel
authors.forename: Wai T
authors.initials: WT
authors.lastname: Wong
authors.forename: Hatice N
authors.initials: HN
authors.lastname: Sen
authors.forename: Brian T
authors.initials: BT
authors.lastname: Chan-Kai
authors.forename: Scott R
authors.initials: SR
authors.lastname: Witherspoon
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Lauer
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
authors.forename: Robert B
authors.initials: RB
authors.lastname: Nussenblatt
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000188:drug therapy; D004343:Drug Implants; D005260:Female; D005451:Fluorescein Angiography; D017245:Foscarnet / Q000008:administration & dosage; D005654:Fundus Oculi; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D004343:Drug Implants; D017245:Foscarnet; D000077562:Valganciclovir; D015774:Ganciclovir