FUNDUS AUTOFLUORESCENCE IN RUBELLA RETINOPATHY: Correlation With Photoreceptor Structure and Function.

PURPOSE: To illustrate altered fundus autofluorescence in rubella retinopathy and to investigate their relationships with photoreceptor structure and function using multimodal imaging. METHODS: The authors report four cases of rubella retinopathy aged 8, 33, 42, and 50 years. All patients had dilated clinical fundus examination; wide-field color photography; blue, green, and near-infrared autofluorescence imaging and spectral domain optical coherence tomography. Two patients also underwent microperimetry and adaptive optics imaging. En face optical coherence tomography, cone mosaic, and microperimetry were coregistered with autofluorescence images. The authors explored the structure-function correlation. RESULTS: All four patients had a "salt-and-pepper" appearance on dilated fundus examination and wide-field color photography. There were variable-sized patches of hypoautofluorescence on both blue and near-infrared excitation in all four patients. Wave-guiding cones were visible and retinal sensitivity was intact over these regions. There was no correlation between hypoautofluorescence and regions of attenuated ellipsoid and interdigitation zones. Hyperautofluorescent lesions were also noted and some of these were pseudo-vitelliform lesions. CONCLUSION: Patchy hypoautofluorescence on near-infrared excitation can be a feature of rubella retinopathy. This may be due to abnormal melanin production or loss of melanin within retinal pigment epithelium cells harboring persistent rubella virus infection. Preservation of the ellipsoid zone, wave-guiding cones, and retinal sensitivity within hypoautofluorescent lesions suggest that these retinal pigment epithelium changes have only mild impact on photoreceptor cell function.

Near-Infrared Autofluorescence Imaging in Geographic Atrophy Using Spectralis Single and Combined Wavelength Modes.

PURPOSE: The Spectralis Heidelberg retina angiography + optical coherence tomography (OCT) device often fails to acquire near-infrared autofluorescence (NI-AF) due to poor signal because of interference by the beam splitter used for aligning the laser source with the OCT diode light source. We report the rates of successful NI-AF image acquisition using indocyanine green angiography (ICGA) mode (without dye) compared with combined fluorescein angiography (FA) + ICGA mode (without dye) in patients with geographic atrophy (GA). DESIGN: This was a retrospective review. METHODS: Two hundred images from 50 eyes of 25 patients with GA were included. All patients underwent NI-AF imaging using ICGA (787 nm) and combined FA + ICGA (488 + 787 nm) modes in both eyes. Each eye had macula- and disc-centered imaging. The rates of successful image acquisition were compared using McNemar test. RESULTS: Successful NI-AF acquisition using ICGA was 48% to 52% in macula-centered views and 36% to 56% in disc-centered views. Only 36% of patients had successful bilateral NI-AF imaging. This improved to 100% in all views in both eyes after switching to combined FA + ICGA mode (P < 0.001). Logistic regression showed no patient or ocular factors were predictive of NI-AF acquisition failure in ICGA mode. CONCLUSIONS: Acquisition of NI-AF images in GA using ICGA mode has a high failure rate, which can be eliminated by using combined FA + ICGA mode. This finding has implications on the design of imaging protocols for routine assessment and clinical trials of geographic atrophy.

Riddle appreciation and reading comprehension in Cantonese-speaking children.

PURPOSE: Inference-making skills are necessary for reading comprehension. Training in riddle appreciation is an effective way to improve reading comprehension among English-speaking children. However, it is not clear whether these methods generalize to other writing systems. The goal of the present study was to investigate the relationship between inference-making skills, as measured by riddle appreciation ability, and reading comprehension performance in typically developing Cantonese-speaking children in the 4th grade. METHOD: Forty Cantonese-speaking children between the ages of 9;1 (years;months) and 11;0 were given tests of riddle appreciation ability and reading comprehension. Chinese character reading and auditory comprehension abilities were also assessed using tests that had been standardized in Hong Kong. RESULTS: Regression analyses revealed that riddle appreciation ability explained a significant amount of variance in reading comprehension after variance due to character reading skills and auditory comprehension skills were first considered. Orthographic, lexical, morphological, and syntactic riddles were also significantly correlated with reading comprehension. CONCLUSION: Riddle appreciation ability predicts reading comprehension in Cantonese-speaking 4th-grade children. Therefore, training Cantonese speakers in riddle appreciation should improve their reading comprehension.