title: Analysis of retinal flecks in fundus flavimaculatus using high-definition spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To assess morphologic changes associated with retinal flecks in fundus flavimaculatus using spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Simultaneous recordings of SD-OCT and confocal scanning laser ophthalmoscope (cSLO) fundus autofluorescence images were obtained in fundus flavimaculatus patients. Morphologic aspects of the retinal flecks were analyzed and classified.
  
  
  RESULTS
  Thirty-one eyes of 17 consecutive patients (8 male, 9 female; mean age 47.9 +/- 17.1 years) were included for analysis. SD-OCT revealed 5 distinct types of lesions. Group A lesions were limited to the outer segment (OS) of the photoreceptors, the retinal pigment epithelium (RPE) interdigitations, and the RPE/Bruch membrane complex. Group B showed a protrusion of the hyper-reflective material through the interface of inner segment (IS)/OS of the photoreceptors up to the external limiting membrane. A further protrusion of the hyper-reflective material into the outer nuclear layer was seen in group C lesions. Group D lesions were characterized by an accumulation of the hyper-reflective material limited to the outer nuclear layer. Type E lesions can be described as drusen-like retinal pigment detachments. No significant correlation between the different types of flecks and visual acuity was observed (P > .05).
  
  
  CONCLUSIONS
  SD-OCT allows one to distinguish at least 5 different types of lesions associated with retinal flecks in fundus flavimaculatus. The ability to characterize the different types of flecks and to analyze the photoreceptor layers surrounding these lesions suggests that SD-OCT might have a potential clinical role in the evaluation and follow-up of the structural changes in fundus flavimaculatus.
authors.affiliation: Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris XII, 40 Avenue de Verdun, Creteil, France.
authors.forename: Monika
authors.initials: M
authors.lastname: Voigt
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Karim
authors.initials: K
authors.lastname: Atmani
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leveziel
authors.forename: Nathalie
authors.initials: N
authors.lastname: Massamba
authors.forename: Nathalie
authors.initials: N
authors.lastname: Puche
authors.forename: Rislie
authors.initials: R
authors.lastname: Bouzitou-Mfoumou
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D012162:Retinal Degeneration / Q000145:classification* / Q000175:diagnosis*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult