Fluorescence lifetime imaging ophthalmoscopy: autofluorescence imaging and beyond

Sauer, Lydia; Vitale, Alexandra; Modersitzki, Natalie K; Bernstein, Paul S.

doi:10.1038/s41433-020-01287-y

Cited by 29 publications

(29 citation statements)

References 82 publications

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“…However, due to the sophisticated requirements, quantitative FAF imaging is not routinely applied today. Another novel imaging technology is fluorescence lifetime imaging ophthalmoscopy (FLIO), which captures metabolic and structural changes based on the measurement of lifetimes of intrinsic retinal autofluorescence [ 96 , 97 ]. To the best of our knowledge, there is no current report on fluorescence lifetimes in patients with choroidal melanoma.…”

Section: Limitationsmentioning

confidence: 99%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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Choroidal melanocytic lesions require reliable and precise clinical examination and diagnosis to differentiate benign choroidal nevi from choroidal melanoma, as the latter may become life-threatening through metastatic disease. To come to an accurate diagnosis, as well as for monitoring, and to assess the efficacy of therapy, various imaging modalities may be used, one of which is non-invasive fundus autofluorescence (FAF) imaging using novel high-resolution digital imaging technology. FAF imaging is based on the visualization of intrinsic fluorophores in the ocular fundus. Lipofuscin and melanolipofuscin within the postmitotic retinal pigment epithelium (RPE) cells represent the major fluorophores that contribute to the FAF signal. In addition, the presence or loss of absorbing molecular constituents may have an impact on the FAF signal. A choroidal melanoma can cause secondary retinal and RPE alterations that affect the FAF signal (e.g., occurrence of orange pigment). Therefore, FAF imaging supports multimodal imaging and gives additional information over and above conventional imaging modalities regarding retinal metabolism and RPE health status. This article summarises the features of FAF imaging and the role of FAF imaging in the context of choroidal melanoma, both before and following therapeutic intervention.

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Section: Limitationsmentioning

confidence: 99%

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Bindewald-Wittich

Holz

Ach

et al. 2022

Cancers

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“…In AMD, FLIO displays a characteristic pattern of ring-shaped prolongation of the FLTs around the fovea, which is present in the early stages of the disease even before the appearance of drusen and increases as the disease progresses (greater in advanced AMD) (461). Apart from this sign, areas of GA and drusen also display FLT prolongation, and this information could be proved useful in the understanding of their pathogenesis and metabolism as well as monitoring their development (461)(462)(463). Since AMD can appear similar to Stargardt disease, FLIO can be used to differentiate the two, since FLTs in Stargardt disease are not prolonged, and the typical ring pattern of AMD is not present.…”

Section: Fluorescence Lifetime Imaging Ophthalmoscopymentioning

confidence: 99%

“…In the case of hydroxychloroquine toxicity, where early toxicity detection is challenging, FLIO could provide a better alternative to electroretinogram (ERG) or OCT, since it can detect prolonged FLTs before structural changes appear (465,466). FLIO has also been used to identify changes in other retinal conditions as well, including DR (Figure 7), vascular occlusive diseases, CSR, choroideremia, RP, and macular holes, and is believed to be a promising diagnostic method (463,(467)(468)(469)(470)(471)(472)(473).…”

Section: Fluorescence Lifetime Imaging Ophthalmoscopymentioning

confidence: 99%

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

et al. 2022

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The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.

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“…Another application, fluorescence lifetime imaging ophthalmoscopy (FLIO) has been in clinical use for 20 years. 29 Recent advances by Vitale et al…”

Section: Autofluorescence Flim Applicationsmentioning

confidence: 99%

Recent innovations in fluorescence lifetime imaging microscopy for biology and medicine

et al. 2021

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Significance: Fluorescence lifetime imaging microscopy (FLIM) measures the decay rate of fluorophores, thus providing insights into molecular interactions. FLIM is a powerful molecular imaging technique that is widely used in biology and medicine.Aim: This perspective highlights some of the major advances in FLIM instrumentation, analysis, and biological and clinical applications that we have found impactful over the last year.Approach: Innovations in FLIM instrumentation resulted in faster acquisition speeds, rapid imaging over large fields of view, and integration with complementary modalities such as singlemolecule microscopy or light-sheet microscopy. There were significant developments in FLIM analysis with machine learning approaches to enhance processing speeds, fit-free techniques to analyze images without a priori knowledge, and open-source analysis resources. The advantages and limitations of these recent instrumentation and analysis techniques are summarized. Finally, applications of FLIM in the last year include label-free imaging in biology, ophthalmology, and intraoperative imaging, FLIM of new fluorescent probes, and lifetime-based Förster resonance energy transfer measurements.Conclusions: A large number of high-quality publications over the last year signifies the growing interest in FLIM and ensures continued technological improvements and expanding applications in biomedical research.

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Fluorescence lifetime imaging ophthalmoscopy: autofluorescence imaging and beyond

Cited by 29 publications

References 82 publications

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

Fundus Autofluorescence Imaging in Patients with Choroidal Melanoma

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

Recent innovations in fluorescence lifetime imaging microscopy for biology and medicine

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