Figure 5.

Digitally-stitched wide-field near-infrared (NIR) reduced-illuminance autofluorescence imaging (RAFI) results of a representative healthy subject compared with five patients with pericentral RD. Upper insets: short-wavelength (SW) RAFI; lower insets: NIR reflectance (REF) images in the same eyes. (A) Near-infrared–RAFI of the 16-year-old normal subject demonstrates higher signal near the fovea smoothly transitioning to a lower signal in the pericentral and midperipheral regions. Blood vessels and the optic nerve appear dark. Short-wavelength–RAFI shows central depression corresponding to the macular pigment absorption. (B–F) Near-infrared–RAFI of pericentral RD patients P6, P12, P16, P19, and P11 demonstrate an annular region (arrowheads) of greater visibility of choroidal pattern of blood vessels implying depigmentation of the RPE and greater penetration of excitation light to choroidal layers. This region is bounded centrally by a relatively preserved macular region with or without regions of atrophy, and a relatively preserved peripheral region beyond the eccentricity of the optic nerve head. Near-infrared–REF images (lower insets) show locally increased reflectivity corresponding to the regions of greater choroidal visibility. Macular SW-RAFI images (upper insets) demonstrate that some of the pericentral demelanization corresponds to RPE atrophy, whereas others retain RPE lipofuscin signal. All images are shown as equivalent right eyes and contrast stretched for visibility of features. Pair of calibrations shown in (F) apply to all panels; both upper and lower insets are displayed at the same magnification.