Systematic analysis of wide-field fundus autofluorescence (FAF) imaging in posterior uveitis

To evaluate wide-field fundus autofluorescence (FAF) in patients with uveitis with retinal or chorioretinal involvement.

We included 78 study eyes in this prospective study. Best-corrected visual acuity, a full clinical examination, wide-field green-light FAF and composite color, green and red laser separation fundus imaging with Optomap SLO were performed. In a systematic analysis, the number, extension and margins of central and peripheral retinal or chorioretinal alterations, scars and infiltrates in infectious and non-infectious uveitic study eyes were evaluated. Wide-field FAF and color fundus imaging results were compared regarding their diagnostic properties.

Nine out of 78 study eyes were diagnosed with infectious, 69 cases with non-infectious uveitis. Six infectious uveitic study eyes had changes of the peripheral fundus compared with 48 of 69 non-infectious uveitic eyes. In 33 (infectious versus non-infectious: 4 versus 29) cases, wide-field FAF images revealed more retinal or chorioretinal alterations or pathologies with a farther extended demarcation than wide-field composite color fundus imaging. Eleven out of 69 non-infectious study eyes were diagnosed with vasculitis which could be more precisely evaluated with wide-field FAF than wide-field composite color, green or red light filtered fundus imaging.

Non-invasive wide-field FAF detects more retinal or chorioretinal involvement in patients with posterior uveitis than seen in color imaging and thus is useful in diagnosis and follow-up of uveitic patients.