title: The role of fundus autofluorescence in late-onset retinitis pigmentosa (LORP) diagnosis.
abstract: OBJECTIVE
  To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa.
  
  
  METHODS
  Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed.
  
  
  RESULTS
  All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing.
  
  
  CONCLUSIONS
  Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis.
authors.affiliation: Cleveland Clinic Lerner College of Medicine, Case Western Reserve University , Cleveland, OH , USA .
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Lee
authors.forename: John C
authors.initials: JC
authors.lastname: Hwang
authors.forename: Royce W S
authors.initials: RW
authors.lastname: Chen
authors.forename: Luiz H
authors.initials: LH
authors.lastname: Lima
authors.forename: Nan-Kai
authors.initials: NK
authors.lastname: Wang
authors.forename: Joaquin
authors.initials: J
authors.lastname: Tosi
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Tsang
mesh_terms: D000368:Aged; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012174:Retinitis Pigmentosa / Q000175:diagnosis*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
keywords: Fundus autofluorescence; late-onset retinitis pigmentosa; magnetic resonance imaging
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