Fundus autofluorescence in exudative age-related macular degeneration

Peng, Qicong; Dong, Y.; Zhao, Puning

doi:10.4238/2013.december.2.11

Cited by 9 publications

(7 citation statements)

References 16 publications

(19 reference statements)

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“… 12 , 29 Discifom scarring consistently demonstrates uneven hypo-autofluorescence of the lesion, surrounded by marked hyper-autofluorescence. 12 , 29 Hemorrhages, 29 , 56 , 57 exudate, 57 and fibrovascular membranes 30 are also likely to cause hypo-autofluorescence patterns. RPE tears show decreased fundus autofluorescence, indicating denuded RPE with surrounding hyper-autofluorescent margins.…”

Section: Resultsmentioning

confidence: 99%

“…Using angiographic characterizations, classic choroidal neovascularization often presents (in 79–90% of cases) with corresponding hypo-autofluorescence, which may be surrounded by a thin halo of hyper-AF in 34 to 50% of cases. 56 , 57 , 59 The halo or ring seen using fundus autofluorescence imaging in classic choroidal neovascularization likely relates to the hyperplastic proliferation of RPE cells around the lesion 56 , 57 , 59 or the presence of macrophages. 57 In contrast, fundus autofluorescence images of occult choroidal neovascularization show irregular (both increased and decreased) fundus autofluorescence signal intensity, with multiple foci of hypo-autofluorescence in at least 50% of cases 57 , 59 and no identifiable junctional zone.…”

Section: Resultsmentioning

confidence: 99%

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Fundus Autofluorescence in Age-related Macular Degeneration

Ly¹,

Nivison‐Smith

Assaad

et al. 2017

Optom Vis Sci

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Fundus autofluorescence (FAF) provides detailed insight into the health of the retinal pigment epithelium (RPE). This is highly valuable in age-related macular degeneration (AMD) as RPE damage is a hallmark of the disease. The purpose of this paper is to critically appraise current clinical descriptions regarding the appearance of AMD using FAF and to integrate these findings into a chair-side reference. A wide variety of FAF patterns have been described in AMD, which is consistent with the clinical heterogeneity of the disease. In particular, FAF imaging in early to intermediate AMD has the capacity to reveal RPE alterations in areas that appear normal on funduscopy, which aids in the stratification of cases and may have visually significant prognostic implications. It can assist in differential diagnoses and also represents a reliable, sensitive method for distinguishing reticular pseudodrusen. FAF is especially valuable in the detection, evaluation, and monitoring of geographic atrophy and has been used as an endpoint in clinical trials. In neovascular AMD, FAF reveals distinct patterns of classic choroidal neovascularization noninvasively and may be especially useful for determining which eyes are likely to benefit from therapeutic intervention. FAF represents a rapid, effective, noninvasive imaging method that has been underutilized, and incorporation into the routine assessment of AMD cases should be considered. However, the practicing clinician should also be aware of the limitations of the modality, such as in the detection of foveal involvement and in the distinction of phenotypes (hypo-autofluorescent drusen from small areas of geographic atrophy).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Fundus Autofluorescence in Age-related Macular Degeneration

Ly¹,

Nivison‐Smith

Assaad

et al. 2017

Optom Vis Sci

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“…In exudative AMD, the developing neovascular lesion can be discerned in SW-AF images early on as a focal hyperautofluorescence [ 99 ]. Later the SW-AF signal is reduced within the lesion [ 99 , 100 ]. In some cases the edge of the neovascular lesion exhibits increased SW-AF signal [ 100 ].…”

Section: Comparison Of Sw- and Nir-af In Amd: Altered Intensities mentioning

confidence: 99%

“…Later the SW-AF signal is reduced within the lesion [ 99 , 100 ]. In some cases the edge of the neovascular lesion exhibits increased SW-AF signal [ 100 ].…”

Section: Comparison Of Sw- and Nir-af In Amd: Altered Intensities mentioning

confidence: 99%

Fundus Autofluorescence and RPE Lipofuscin in Age-Related Macular Degeneration

Sparrow

Duncker

2014

JCM

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Genes that increase susceptibility to age-related macular degeneration (AMD) have been identified; however, since many individuals carrying these risk alleles do not develop disease, other contributors are involved. One additional factor, long implicated in the pathogenesis of AMD, is the lipofuscin of retinal pigment epithelium (RPE). The fluorophores that constitute RPE lipofuscin also serve as a source of autofluorescence (AF) that can be imaged by confocal laser ophthalmoscopy. The AF originating from lipofuscin is excited by the delivery of short wavelength (SW) light. A second autofluorescence is emitted from the melanin of RPE (and choroid) upon near-infrared (NIR-AF) excitation. SW-AF imaging is currently used in the clinical management of retinal disorders and the advantages of NIR-AF are increasingly recognized. Here we visit the damaging properties of RPE lipofuscin that could be significant when expressed on a background of genetic susceptibility. To advance interpretations of disease-related patterns of fundus AF in AMD, we also consider the photochemical and spectrophotometric features of the lipofuscin compounds responsible for generating the fluorescence emission.

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“…The author also compared the FAF image with fundus fluorescence angiography; the The Role of Imaging in Age-Related Macular Degeneration DOI: http://dx.doi.org/10.5772/intechopen.82630 lesion on FFA appeared smaller than that in FAF showing that FAF has more advantages in detailing the alteration in RPE. In occult neovascular ARMD, FAF images exhibit diverse FAF characteristics with both reduced FAF and elevated patchy FAF [25]. FAF has high sensitivity in detecting neovascular ARMD (93%) but relatively low specificity (37%) in comparison with FFA as the gold standard [24].…”

Section: The Fundus Autofluorescencementioning

confidence: 99%

The Role of Imaging in Age-Related Macular Degeneration

Victor¹

2020

Visual Impairment and Blindness - What We Know and What We Have to Know

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Age-related macular degeneration (ARMD) is the leading cause of blindness affecting adults. The disease alters the macula, center of the retina, responsible for the keenest vision. Although ARMD is part of the aging process, the exact pathophysiology is still unknown. The evidence suggests that oxidative stress, lipofuscin accumulation, drusen accumulation, chronic inflammation, choroidal neovascularization, and mutations of the complement contribute to the development of ARMD. Early recognition and prompt treatment halt the progression of the disease. The advanced technology in imaging modalities provides comprehensive and complete management at the earliest stage of ARMD.Keywords: macular degeneration, age-related macular degeneration, imaging, fundus photography, fundus autofluorescence, fundus fluorescence angiography, indocyanine green angiography, optical coherence tomography, optical coherence tomography angiography Visual Impairment and Blindness -What We Know and What We Have to Know 2 2. An overview of age-related macular degeneration Age-related macular degeneration is commonly classified based on its characteristics into dry (nonexudative) ARMD and wet (exudative) ARMD [5,7]. Meanwhile, according the natural course of the disease, it categorizes into early, intermediate, and advanced ARMD [6,7]. Dry ARMD represents approximately 90% of diagnosed ARMD cases [5,7]. This type is distinguished by the present drusen accumulation, the absence of choroid neovascularization, and retinal pigment epithelium (RPE) atrophy [8]. The hallmark of wet ARMD is the development of choroidal neovascularization, and this fragile new blood vessel tends to leak forming exudates [9]. It counts for 10% of ARMD cases and has been linked with rapid deterioration toward blindness [7].Beyond aging process, smoking and ethnicity are the only consistent risk factors related with ARMD documented in studies. A cohort study of 65 years old or older patients found smoking doubles the risk of having ARMD in 5 years compared to nonsmokers [10]. The exact underlying pathophysiology of ARMD is still unknown. Several theories are hypothesized to be the fundamental factors behind ARMD. These include lipofuscin accumulation, drusen accumulation, chronic inflammation, oxidative stress, reduction of antioxidant, mutation of complements, and choroidal neovascularization [10,11]. The new blood vessels are fragile and generate complications to the surrounding structure causing hemorrhages, exudate, RPE and/or retinal detachment, and scar, hence the progression into the end-stage ARMD, which is exudative ARMD [5,6,9,12].The identification of ARMD in patients is a crucial aspect in delivering early treatment. Elder patients especially those aged above 40 years are more susceptible to develop ARMD. According to the American Academy of Ophthalmology, it is suggested that individuals aged 40 years and above should be screened for the possible ARMD. Binocular slit-lamp examination with three mirror lens or condensing lens is also needed to disclose drus...

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Fundus autofluorescence in exudative age-related macular degeneration

Cited by 9 publications

References 16 publications

Fundus Autofluorescence in Age-related Macular Degeneration

Fundus Autofluorescence in Age-related Macular Degeneration

Fundus Autofluorescence and RPE Lipofuscin in Age-Related Macular Degeneration

The Role of Imaging in Age-Related Macular Degeneration

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