First Author: K.Spiteri Cornish UK
Co Author(s): P.Y.S. Chua V. McBain 0 0 0 0 0 0 0 0 0
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Pattern dystrophy (PD) consists of a range of diseases including adult vitelliform dystrophy, reticular, butterfly and multifocal dystrophy. Diagnosis is not always simple, and may require more than one diagnostic tool. The aim of our study is to look at the use of autofluorescence and its specificity and sensitivity in the diagnosis of PD.
Retinal Imaging Service in Aberdeen University Hospital, Aberdeen, UK.
Retrospective review of all cases referred in the past 7 years with a possible diagnosis of PD. Case notes and all images and investigations were independantly analysed by one clinician (KSC) and consultant clinical scientist (VMB). The specificity and sensitivity of AF in the diagnosis of PD was calculated. Patient demographics, clinical findings and the use of ancillary testing in aiding diagnosis (such as OCT, FFA, Genetics, Electrodiagnostics) was looked at.
A total of 72 cases were referred to the retinal imaging and electrophysiology department with a provisional diagnosis of PD. Of these, 35 were confirmed as PD. OCT and AF were used in all cases except one (service not available on one occasion). However, AF was the singlemost accurate and useful imaging tool that led to the positive diagnosis of PD, with a sensitivity of 88.9% and specificity of 72%. EOG was performed in 30 patients and was reduced in 12 (40%), which is inkeeping with current literature.
Autofluorescence was found to be a highly sensitive imaging tool in the diagnosis of PD. Where diagnosis was equivocal, EOG, OCT, FFA and Genetic testing were useful secondary tests. We believe AF should be used alone to diagnose and follow-up most cases of PD, and complemented by other tests when the diagnosis is not clear. This helps streamline and contain cost in this clinical setting. Clinical findings and signs on autofluorescence will be highlighted in the presentation.