Fundus autofluorescence in choroidal metastatic lesions a pilot study

Purpose: To correlate fundus autofluorescence (FAF) in choroidal metastases with clinical changes overlying the lesions using confocal scanning laser ophthalmoscope. Methods: Retrospective chart review of 15 metastatic tumors in 14 eyes of 11 consecutive patients. The patients underwent confocal scanning laser ophthalmoscope to compare the clinical findings and FAF. Correlation between increased FAF and clinical changes was defined as complete, partial, or no correlation. Results: Of 11 patients, 8 (73%) were women, and the average age was 56 years. All 15 metastases were amelanotic, focal hyperpigmentation was present in 8 (53%), subretinal fluid in eleven (73%), whereas drusen and orange pigment were absent. Of 8 tumors that were visualized by scanning laser ophthalmoscope, 7 tumors (87%) showed correlation between FAF and hyperpigmentation, no correlation in 1 (13%). A complete correlation between hyperpigmentation and FAF was found in 5 (70%) tumors and a partial correlation in 2 (30%). There was partial correlation between subretinal fluid and FAF in 6 metastases (46%), no correlation in 5 (39%). Three metastases without hyperpigmentation had FAF, one showed the presence of subretinal fluid. Conclusion: Amelanotic choroidal metastases with hyperpigmentation are associated with increased FAF in most cases. Subretinal fluid overlying choroidal metastases may cause FAF as well. RETINA 28:1251-1256, 2008