case_images: PMC5687493_01
case_images: Patient with age-related macular degeneration and widespread perimacular and peripheral abnormalities. Ultra-widefield pseudocolor images of the right eye demonstrate foveal retinal pigment epithelium (RPE) changes along with macular drusen in all quadrants. There are extensive drusenoid changes in the perimacular area in the temporal quadrants, as well as mid-peripheral and far-peripheral drusen and RPE changes (A-C). Analogous to this, ultra-widefield autofluorescence shows mixed hyper/hypoautofluorescence in the macula and hyperautofluorescence in the perimacula. The mid- and far periphery show partially mottled hyperautofluorescence (D-F). Upgaze (A and D); primary gaze (B and E), downgaze (C and F).
case_images: opth-11-1967Fig3.jpg
case_images: PMC5687493_01_opth-11-1967Fig3.jpg
case_images: f3-opth-11-1967
case_images: In the right eye (Figure 3), there were central RPE changes and macular drusen (Figure 3A-C). There was some RPE atrophy demonstrated by perifoveal hypoautofluorescence (Figure 3D-F). The perimacular zone demonstrated extensive drusen, most prominent inferotemporally and more moderate superotemporally and superonasally (Figure 3A and C), with very few drusen present inferonasally (Figure 3C and F). These drusen extended into the mid periphery and were best seen in upgaze (Figure 3A and D). A few loose drusen were also present in mid periphery inferonasally and inferotemporally, best seen in downgaze (Figure 3C and F). The nasal far periphery also harbored drusen, best seen in upgaze for the superonasal quadrant (Figure 3A and E) and in downgaze for the inferonasal quadrant (Figure 3C and F). There were isolated drusen in the far periphery superotemporally (Figure 3A), but no pathological abnormalities were seen inferotemporally (Figure 3C and F).
case_images: PMC5687493_02
case_images: Patient with age-related macular degeneration and peripheral abnormalities. Ultra-widefield pseudocolor images of the left eye demonstrate juxtafoveal geographic atrophy and macular drusen, partially extending into the perimacular region. There are a few drusen, mostly in the nasal far periphery, but also inferior along the border of mid- and far periphery (A-C). Corresponding autofluorescence images demonstrate brisk hypoautofluorescence juxtafoveally with adjacent hyperautofluorescence. There is hyperautofluorescence, which extends into the temporal perimacular as well as speckled hyperautofluorescence, mostly nasally and inferiorly (D-F). Upgaze (A and D); primary gaze (B and E), downgaze (C and F).
case_images: opth-11-1967Fig4.jpg
case_images: PMC5687493_02_opth-11-1967Fig4.jpg
case_images: f4-opth-11-1967
case_images: The right eye (Figure 4) demonstrated juxtafoveal geographic atrophy as well as several drusen (Figure 4A-C). Few drusen extended into the temporal perimacular area (Figure 4). There was a cluster of nasal and superonasal drusen in the far periphery (Figure 4A, B, D and E). Few drusen were present in the superotemporal and inferotemporal mid- and far periphery, best seen on auto-fluorescence images (Figure 4D-F). The inferior fundus had several drusen, mostly along the border of the mid- and far periphery (Figure 4C-F). The patchy color changes in the temporal far periphery on pseudocolor images (Figure 4A and B) were artifacts and had no correlation on respective autofluorescence images (Figure 4D and E).
case_images: PMC5687493_03
case_images: Patient without age-related macular degeneration and nonspecific peripheral retinal changes. Ultra-widefield pseudocolor images of the right eye demonstrate normal macula and a few nonspecific changes in the peripheral retina (A-C). Autofluorescence imaging demonstrates focal retinal pigment epithelium atrophy in the superonasal mid periphery as well as patchy hyperautofluorescence inferotemporally along the border of mid- and far periphery (D-F). Upgaze (A and D); primary gaze (B and E), downgaze (C and F).
case_images: opth-11-1967Fig5.jpg
case_images: PMC5687493_03_opth-11-1967Fig5.jpg
case_images: f5-opth-11-1967
case_images: In the right eye, the macula appeared normal without any drusen or RPE atrophy (Figure 5). There was focal RPE atrophy in the superonasal quadrant of the mid periphery (Figure 5A and D). There were nonspecific patchy hyperautofluorescent changes in the inferotemporal quadrant of the mid- and far periphery (Figure 5F). Speckled dots in the superior fundus were seen on pseudocolor images (Figure 5A) representing artifacts instead of drusen, and there was no correlation on autofluorescence imaging (Figure 5D).