Retinal pigment epithelium imaging focuses on the layer of pigmented cells beneath the photoreceptors that supports retinal metabolism. It is central to understanding many macular and inherited retinal conditions.
Methods
Fundus autofluorescence highlights lipofuscin within retinal pigment epithelium cells, showing areas of stress or loss, while OCT depicts their structural contour and relationship to overlying retina and underlying Bruch’s membrane. Angiography can reveal associated changes in the choroidal circulation.
- Autofluorescence patterns vary between diseases and disease stages
- OCT shows detachments, atrophy, or irregular thickening
- Combination of modalities gives both structural and metabolic information
- Serial imaging tracks progression of atrophic or neovascular processes
Clinical Role
Retinal pigment epithelium imaging is crucial in age-related macular degeneration, Stargardt disease, central serous chorioretinopathy, and other dystrophies. It guides treatment decisions and prognosis.
- Helps map areas of geographic atrophy and predict future spread
- Distinguishes active disease from established scarring
- Supports selection and monitoring of patients in clinical trials
- Interpretation requires awareness of normal age-related autofluorescence
