Granular lesions of short-wavelength and near-infrared autofluorescence in diabetic macular oedema

摘要： Objectives To document and characterise hyper- and hypo-re?ective lesions, which we describe as ‘granular’ on short-wavelength auto?uorescence (SW-AF) and near-infrared (NIR)-AF images in diabetic macular oedema (DMO). Methods Consecutive 103 eyes of 78 patients suffering from centre-involving DMO were reviewed retrospectively. Mosaics of hyper- and hypo-?uorescent dots on both SW-AF and NIR-AF signals were delineated and de?ned as granular lesions in the macula. We evaluated the association of such lesions with the logarithm of the minimum angle of resolution visual acuity (logMAR VA) and spectral-domain optical coherence tomography (SD-OCT) images. Results Diffuse mosaics of hyper- and hypo-?uorescent dots were delineated in 36 and 45 eyes on SW-AF and NIR-AF images, respectively, and both AF images de?ned granular lesions in 33 eyes. These lesions were delineated in both the fovea and extrafoveal areas on NIR-AF images but were limited to the parafoveal and perifoveal sub?elds on SW-AF images. There was a signi?cant difference in logMAR VA between eyes with and without granular lesions (0.358 ± 0.269 vs. 0.185 ± 0.234; P = 0.001). Granular lesions were associated with the mosaic pattern on NIR-AF images (P < 0.001) but not with other parameters on SW-AF and NIR-AF images. The retinal thickness in the central sub?eld was greater in eyes with granular lesions (538.0 ± 163.6 μm vs. 448.8 ± 120.2 μm; P = 0.003). Granular lesions were associated with ELM disruption and hyper-re?ective foci in the outer retinal layers (P = 0.004 and P = 0.037, respectively). Conclusions Granular lesions de?ned on both SW-AF and NIR-AF images were related to retinal oedema with photoreceptor damage and concomitant VA reduction in DMO.