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Longitudinal Structural and Functional Evaluation of Dark-without-Pressure Fundus Lesions in Patients with Autoimmune Diseases

Lombardo M, Ricci F, Cusumano A, Falsini B, Nucci C, Cesareo M

Diagnostics (Basel, Switzerland), 2024

1 citation

Abstract

Objectives: The main objective of this study was to report and investigate the characteristics and longitudinal changes in dark-without-pressure (DWP) fundus lesions in patients with autoimmune diseases using multimodal imaging techniques.

Methods: In this retrospective observational case series, five patients affected by ocular and systemic autoimmune disorders and DWP were examined. DWP was assessed by multimodal imaging, including color fundus photography (CFP), near-infrared reflectance (NIR), blue reflectance (BR), blue autofluorescence (BAF), optical coherence tomography (OCT), OCT-angiography (OCT-A), fluorescein angiography (FA) and indocyanine green angiography (ICGA), and functional testing, including standard automated perimetry (SAP) and electroretinography (ERG). Follow-up examinations were performed for four out of five patients (range: 6 months-7 years).

Results: DWP fundus lesions were found in the retinal mid-periphery and were characterized by the hypo-reflectivity of the ellipsoid zone on OCT. DWP appeared hypo-reflective in NIR, BR and BAF, and exhibited hypo-fluorescence in FA in two patients while showing no signs in one patient. ICGA showed hypo-fluorescent margins in one patient. SAP and ERG testing did not show alterations attributable to the DWP lesion. Follow-up examinations documented rapid dimensional changes in DWP even in the short term (1 month).

Conclusions: This study suggests a possible association between autoimmune diseases and DWP. New…

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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