Influence of lens opacities and cataract severity on quantitative fundus autofluorescence as a secondary outcome of a randomized clinical trial

Reiter, Gerhard; Schartmüller, Daniel; Röggla, Veronika; Leydolt, Christina; Menapace, Rupert; Schmidt‐Erfurth, Ursula; Sacu, Stefan

doi:10.1038/s41598-021-92309-6

Cited by 14 publications

(17 citation statements)

References 28 publications

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“…The highest grading criteria were reached for absence of vignetting (eg, for IR images 9.4±0.8) and centration (eg, for IR images 8.2±1.4). Lower values were documented for focus with 8.4±1.44–10 for IR, 7±2.31–10 for BAF and 7.3±2.31–10 for GAF imaging. The mean value for illumination was 8.2±1.4 (3.5–10) for IR, 7±2.31–10 for BAF and 7.2±2.7 for GAF with similar image quality values for symmetry.…”

Section: Resultsmentioning

confidence: 92%

“…Lower values were documented for focus with 8.4±1.44–10 for IR, 7±2.31–10 for BAF and 7.3±2.31–10 for GAF imaging. The mean value for illumination was 8.2±1.4 (3.5–10) for IR, 7±2.31–10 for BAF and 7.2±2.7 for GAF with similar image quality values for symmetry.…”

Section: Resultsmentioning

confidence: 92%

“…In clinical settings, blue (BAF) and green FAF (GAF) imaging heavily relies on the clarity of optical media, such as the cornea, the lens and the vitreous 6. With age, glycation products amass in the lenticular fibres, leading to increased opacity7 causing reduced transmission of external light to the retina.…”

Section: Introductionmentioning

confidence: 99%

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Impact of lens autofluorescence and opacification on retinal imaging

von der Emde,

Rennen,

Vaisband

et al. 2024

BMJ Open Ophth

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BackgroundRetinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties that distort image analysis. Here, we report both lens opacification and AF metrics and the effect on automated image quality assessment.Methods227 subjects (range: 19–89 years old) received quantitative AF of the lens (LQAF), Scheimpflug, anterior chamber optical coherence tomography as well as blue/green FAF (BAF/GAF), and infrared (IR) imaging. LQAF values, the Pentacam Nucleus Staging score and the relative lens reflectivity were extracted to estimate lens opacification. Mean opinion scores of FAF and IR image quality were compiled by medical readers. A regression model for predicting image quality was developed using a convolutional neural network (CNN). Correlation analysis was conducted to assess the association of lens scores, with retinal image quality derived from human or CNN annotations.ResultsRetinal image quality was generally high across all imaging modalities (IR (8.25±1.99) >GAF >BAF (6.6±3.13)). CNN image quality prediction was excellent (average mean absolute error (MAE) 0.9). Predictions were comparable to human grading. Overall, LQAF showed the highest correlation with image quality grading criteria for all imaging modalities (eg, Pearson correlation±CI −0.35 (−0.50 to 0.18) for BAF/LQAF). BAF image quality was most vulnerable to an increase in lenticular metrics, while IR (−0.19 (−0.38 to 0.01)) demonstrated the highest resilience.ConclusionThe use of CNN-based retinal image quality assessment achieved excellent results. The study highlights the vulnerability of BAF to lenticular remodelling. These results can aid in the development of cut-off values for clinical studies, ensuring reliable data collection for the monitoring of retinal diseases.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 92%

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Impact of lens autofluorescence and opacification on retinal imaging

von der Emde,

Rennen,

Vaisband

et al. 2024

BMJ Open Ophth

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“… 12 However, our previous studies using histology as well as studies displaying marked differences of QAF dependent on lens opacification challenge this theory. 7 , 24 A decrease in QAF at higher age (>80 years), however, is possible but remains to be tested. In AMD, however, the relationship is not as straightforward.…”

Section: Discussionmentioning

confidence: 99%

Autofluorescent Organelles Within the Retinal Pigment Epithelium in Human Donor Eyes With and Without Age-Related Macular Degeneration

Bermond

Emde

Tarau

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose Human retinal pigment epithelium (RPE) cells contain lipofuscin, melanolipofuscin, and melanosome organelles that impact clinical autofluorescence (AF) imaging. Here, we quantified the effect of age-related macular degeneration (AMD) on granule count and histologic AF of RPE cell bodies. Methods Seven AMD-affected human RPE-Bruch's membrane flatmounts (early and intermediate = 3, late dry = 1, and neovascular = 3) were imaged at fovea, perifovea, and near periphery using structured illumination and confocal AF microscopy (excitation 488 nm) and compared to RPE-flatmounts with unremarkable macula ( n = 7, >80 years). Subsequently, granules were marked with computer assistance, and classified by their AF properties. The AF/cell was calculated from confocal images. The total number of granules and AF/cell was analyzed implementing a mixed effect analysis of covariance (ANCOVA). Results A total of 152 AMD-affected RPE cells were analyzed (fovea = 22, perifovea = 60, and near-periphery = 70). AMD-affected RPE cells showed increased variability in size and a significantly increased granule load independent of the retinal location (fovea: P = 0.02, perifovea: P = 0.04, and near periphery: P < 0.01). The lipofuscin fraction of total organelles decreased and the melanolipofuscin fraction increased in AMD, at all locations (especially the fovea). AF was significantly lower in AMD-affected cells (fovea: <0.01, perifovea: <0.01, and near periphery: 0.02). Conclusions In AMD RPE, lipofuscin was proportionately lowest in the fovea, a location also known to be affected by accumulation of soft drusen and preservation of cone-mediated visual acuity. Enlarged RPE cell bodies displayed increased net granule count but diminished total AF. Future studies should also assess the impact on AF imaging of RPE apical processes containing melanosomes.

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“…When measuring the fluorescence from the fundus, the age-related changes in absorption properties and fluorescence of the lens need to be taken into consideration [303][304][305][306]. With age, there is a progressive build-up of lenticular chromophores absorbing initially ultraviolet, then violet, blue light, and eventually even longer-wavelength light [149].…”

Section: Imaging Of Fluorescence In the Retinamentioning

confidence: 99%

Lipofuscin, Its Origin, Properties, and Contribution to Retinal Fluorescence as a Potential Biomarker of Oxidative Damage to the Retina

Różanowska¹

2023

Preprint

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Lipofuscin accumulates with age as intracellular fluorescent granules originating from incomplete lysosomal digestion of phagocytosed and autophagocytosed material. The purpose of this review is to provide an update on the current understanding of the role of oxidative stress and/or lysosomal dysfunction in lipofuscin accumulation and its consequences, particularly for retinal pigment epithelium (RPE). Next, the fluorescence of lipofuscin, spectral changes induced by oxidation, and its contribution to retinal fluorescence are discussed. This is followed by reviewing recent developments in fluorescence imaging of the retina, and the current evidence on the prognostic value of retinal fluorescence for the progression of age-related macular degeneration (AMD), the major blinding disease affecting elderly people in developed countries. The evidence of lipofuscin oxidation in vivo, and the evidence of increased oxidative damage in AMD retina ex vivo lead to the conclusion that imaging of spectral characteristics of lipofuscin fluorescence may serve as a useful biomarker of oxidative damage which can be helpful in assessing the efficacy of potential antioxidant therapies in retinal degenerations associated with accumulation of lipofuscin and increased oxidative stress. Finally, amendments to currently used fluorescence imaging instruments are suggested, to be more sensitive and specific for imaging spectral char-acteristics of lipofuscin fluorescence.

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Influence of lens opacities and cataract severity on quantitative fundus autofluorescence as a secondary outcome of a randomized clinical trial

Cited by 14 publications

References 28 publications

Impact of lens autofluorescence and opacification on retinal imaging

Impact of lens autofluorescence and opacification on retinal imaging

Autofluorescent Organelles Within the Retinal Pigment Epithelium in Human Donor Eyes With and Without Age-Related Macular Degeneration

Lipofuscin, Its Origin, Properties, and Contribution to Retinal Fluorescence as a Potential Biomarker of Oxidative Damage to the Retina

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