Fundus autofluorescence in choroidal melanocytic lesions

PURPOSE: To correlate fundus autofluorescence (FAF) patterns in choroidal melanocytic lesions with changes present on the surface of such lesions, including lipofuscin, hyperpigmentation, drusen, and fibrous metaplasia. METHODS: Retrospective chart review for 23 consecutive patients with choroidal nevi and melanoma who underwent FAF photography. The correlation between increased FAF patterns and foci of lipofuscin, hyperpigmentation, drusen, or fibrous metaplasia was defined as complete correlation, partial correlation, or no correlation. RESULTS: Lipofuscin was present in 13 tumors, hyperpigmentation was present in 9 tumors, drusen were present in 6 tumors, and fibrous metaplasia was present in 4 tumors. Complete correlation between increased FAF and lipofuscin was found in 8 tumors (61.5%); partial correlation, in 3 tumors (23.1%); and no correlation, in 2 tumors (15.4%). Complete correlation between hyperpigmentation and increased FAF was found in 5 tumors (55.6%); partial correlation, in 3 tumors (33.3%); and no correlation, in 1 tumor (11.1%). Partial correlation was found between drusen and increased FAF in 4 tumors. Partial correlation was found between fibrous metaplasia and increased FAF in three tumors. CONCLUSION: Choroidal melanocytic lesions with overlying lipofuscin and hyperpigmentation are associated with increased FAF in ≈90% of cases.