Elsevier

Ophthalmology

Volume 110, Issue 2, February 2003, Pages 392-399
Ophthalmology

Fundus autofluorescence and age-related macular degeneration

Presented in part at the annual meeting of the American Academy of Ophthalmology, November 14, 2001.
https://doi.org/10.1016/S0161-6420(02)01756-6Get rights and content

Abstract

Purpose

To evaluate the autofluorescence images of patients with nonexudative and the fellow eyes with exudative age-related macular degeneration (AMD).

Design

Observational case series.

Participants

Fifty-four patients seen in the author’s practice.

Methods

A fundus camera–based system for autofluorescence photographs was used, and the wavelengths for the excitation (580 nm) and barrier (695 nm) filters were based on known transmission and autofluorescent characteristics of the ocular media. Patients were also photographed with red-free and infrared monochromatic imaging. The mean levels of autofluorescence were compared between patients without (group 1) and those with exudative AMD. Comparisons were made among patients with exudative AMD, examining the autofluorescence pattern in those without retinal vascular contribution to the exudative process (group 2) to those with retinal vascular contribution (group 3).

Main outcome measures

Mean amounts and patterns of autofluorescence.

Results

A total of 54 patients was evaluated; 18 were in each group. The mean age was 75.4 years, and there was no difference in the mean ages among the groups (P = 0.16). There was no correlation of the autofluorescence measurements and the degree of nuclear sclerosis (P = 0.14). Patients with exudative AMD had more autofluorescence in the fellow eye than did eyes of patients without exudative AMD (P = 0.002). Patients in group 3 were more likely to have focal hyperpigmentation, particularly as imaged by infrared light (P = 0.015), and focal areas of intense autofluorescence (P = 0.001) than were patients in group 2.

Conclusions

By use of this method of autofluorescence imaging, it was determined that the fellow eyes of patients with exudative AMD had larger amounts of autofluorescence than did the eyes of patients without a history of exudative AMD. Patients with retinal vascular anastomosis to the vascular proliferation of exudative AMD were much more likely to have focal areas of intense autofluorescence in their fellow eye that corresponded, for the most part, with focal areas of hyperpigmentation best seen by infrared monochromatic fundus photography. Because the amount of fluorescence is directly related to the amount of lipofuscin, which in turn is related to the cumulative amount of oxidative damage, these findings suggest possible explanations for certain patterns of vessel growth seen in exudative AMD.

Section snippets

Patients and methods

The patients in this study were examined in the author’s practice. Each patient underwent distance visual acuity measurement, general ophthalmic examination, including slit-lamp biomicroscopy, indirect ophthalmoscopy, and fundus photography, using the methods described. The amount of nuclear sclerosis was evaluated from 0 to 4+. The patients also had fluorescein and indocyanine green angiography as indicated to help establish the diagnosis of exudative age-related macular degeneration (AMD) as

Results

A total of 54 patients was imaged with all modalities; in 18 there was no exudative AMD in the fellow eye (group 1), in 18 there was exudative AMD with no retinal vascular contribution (group 2), and 18 had exudative AMD with retinal vascular contribution (group 3). The mean age of all patients was 75.4 years (standard deviation, 7.7 years), and there was no difference in the mean ages of the groups (P = 0.16, one-way analysis). The Pearson correlation coefficient for the association between

Discussion

This study found, using a fundus camera based system, that the autofluorescence in the fellow eyes of patients with exudative AMD had larger amounts of autofluorescence than did the eyes of patients without a history of exudative AMD. The fellow eyes of patients with retinal vascular contribution to the vascular proliferation of exudative AMD were much more likely to have focal areas of intense autofluorescence that corresponded for the most part with focal areas of hyperpigmentation best seen

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  • Cited by (0)

    Manuscript no. 210607.

    Supported by The Macula Foundation, Inc., New York, New York.

    The author has no financial interest in any aspect of this study.

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