Fundus fluorescein angiography in generalized scleroderma

Fundus affliction with generalized scleroderma was studied in 21 patients by ophthalmoscopy, fundus ocular photography and fluorescein angiography. Slitlamp examination of the anterior chamber, the iris and the lens revealed no evident affections. Neither did ophthalmoscopy reveal obvious abnormalities related to scleroderma. Abnormalities of pigmentation were not noted. Visual acuity was normal in 20 patients, and 1 patient had reduced visual acuity due to macular degeneration. Fundus fluorescein angiography was within normal physiological variation in 14, and definitely abnormal in 7 patients as assessed independently by 2 ophthalmologists. Angiographic abnormalities consisted of variable hyperfluorescence of the pigment epithelium layer, and, additionally, in 2 cases minute hyperfluorescence of the retinal layer. These angiographic abnormalities indicated affection of the retinal pigment epithelium probably caused by a vascular lesion of the choroidal layer. Retinal vessels were in general not affected. In conclusion, the choroidal vasculature appears affected in 1/3 of patients with generalized scleroderma as assessed by fundus fluorescein angiography.