RCOphth Annual Congress 2026

Background:

Autofluorescence is an increasingly useful tool

A blue light is used to excite natural fluorophores in the retina which then further emit light

Patterns of autofluorescence can aide diagnosis and determine prognosis

We report on a series of four children with hyperautofluorescent parafoveal rings with four different genetic variants for retinal dystrophy

Methods:

This is a retrospective review of 4 children from a paediatric ophthalmology clinic in the UK. Clinical data and results of retinal imaging including autofluorescence and OCT macula are reported.

Key Findings:

All children exhibited a similar pattern and location of parafoveal hyperautofluorescent rings, around the central macula but non-foveal involving
Vision ranged between -0.14 to 0.42 LogMAR in the better seeing eye of each patient

Retinal findings on fundoscopy ranged from bone spicule retinopathy, to a normal retina on examination

Literature review:

A hyperautofluorescent parafoveal ring is a recognised fundus autofluorescence pattern reflecting a metabolic transition zone between relatively preserved central retina and surrounding photoreceptor degeneration
Recent reports have shown hyperautofluorescent rings as a prognostic marker for slower progression in the context of retinitis pigmentosa

These rings can sometimes be the earliest or sole abnormality, preceding fundoscopic change, visual field loss, or electroretinographic abnormalities

Conclusion:

Our report demonstrates the utility of autofluorescence in children. This is particularly useful in the cohort who report unexplained reduced vision in dark or light conditions with minimal retinal findings. Recognition of the hyperautofluorescent parafoveal ring can support earlier diagnosis, guide prognosis, and facilitate genetic testing and counselling.

RCOphth Annual Congress 2026

Hyperautofluorescent parafoveal ring in children with rod-cone dystrophy and literature review

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