Near-Infrared Autofluorescence Imaging of the Fundus: Visualization of Ocular Melanin

Keilhauer, Claudia N.; Delori, Franc ̧ois C.

doi:10.1167/iovs.06-0122

Cited by 351 publications

(322 citation statements)

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“…There is consistent evidence based on the distribution of NIA corresponding to RPE melanin distribution, 31 the contribution of RPE and choroid to NIA and the markedly increased NIA in choroidal nevi that the major contribution to NIA is derived from ocular melanin, although a minor contribution of other fluorophores can not be excluded at present. 19 Increased NIA corresponds to increased melanin levels (eg, in choroidal nevi), reduced NIA to deficient RPE cells in chloroquine retinopathy, agerelated macular degeneration, or Stargardt disease. [18][19][20][21] Three possible mechanisms could explain the altered NIA distribution in RP.…”

Section: Discussionmentioning

confidence: 99%

“…19 Increased NIA corresponds to increased melanin levels (eg, in choroidal nevi), reduced NIA to deficient RPE cells in chloroquine retinopathy, agerelated macular degeneration, or Stargardt disease. [18][19][20][21] Three possible mechanisms could explain the altered NIA distribution in RP. First, an increase of melanin, melanolysosomes, or melanolipofuscin content in the RPE cell may occur.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 Choroidal melanin is an additional, minor source of NIA. 19 NIA abnormalities have been reported in age-related macular degeneration, 18,19 Stargardt disease, 20 chloroquine retinopathy, 21 some forms of RP, 22,23 and Usher syndrome. 24 Both imaging methods, FAF and NIA, are non-invasive without any application of dye and can be repeated frequently if necessary.…”

Section: Introductionmentioning

confidence: 99%

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Lipofuscin- and melanin-related fundus autofluorescence visualize different retinal pigment epithelial alterations in patients with retinitis pigmentosa

Kellner

Weber

et al. 2008

Eye

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Aims To compare melanin-related nearinfrared fundus autofluorescence (FAF; NIA, excitation 787 nm, emission 4800 nm) with lipofuscin-related FAF (excitation 488 nm, emission 4500 nm) in retinitis pigmentosa (RP). Methods Thirty-three consecutive RP patients with different modes of inheritance were diagnosed clinically, with full-field ERG, and if possible with molecular genetic methods. FAF and NIA imaging were performed with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2). Results Rings of increased FAF were present within an area of preserved retinal pigment epithelium (RPE) at the posterior pole (31/33). Rings of increased NIA were located in the same region as rings of increased FAF. In contrast to FAF, NIA showed a precipitous decline of NIA peripheral to the ring. In larger areas of preserved NIA (11/31), pericentral and foveal NIA were of similar intensity with an area of lower NIA in between. In smaller areas of preserved NIA (20/31), NIA was homogeneous from the perifovea to the fovea. In one patient without a ring of increased FAF, NIA distribution was normal. In the remaining patient with severely advanced RP, no residual RPE as well as no FAF and NIA were detectable. Conclusion Characteristic features for FAF and NIA alterations in a heterogeneous group of RP patients indicate a common pathway of RPE degeneration. Patterns of NIA and FAF indicate different pathophysiologic processes involving melanin and lipofuscin. Combined NIA and FAF imaging will provide further insight into the pathogenesis of RP and noninvasive monitoring of future therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lipofuscin- and melanin-related fundus autofluorescence visualize different retinal pigment epithelial alterations in patients with retinitis pigmentosa

Kellner

Weber

et al. 2008

Eye

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“…This higher percentage is probably related to the fact that the technique used in this study also took into account the more individually determined choroidal melanin, in addition to RPE melanin. In a recent study, Keilhauer and Delori (2006) used near infrared autofluorescence imaging for the detection of RPE-and choroidal melanin. They found no significant interocular differences in the ratio of foveal to parafoveal autofluorescence (n ¼ 36, paired t ¼ À1.0, P ¼ 0.3) and the correlation between eyes was significant (r ¼ þ0.55, P ¼ 0.001).…”

Section: Discussionmentioning

confidence: 99%

Interocular agreement in melanin and macular pigment optical density

Kanis

Berendschot

Norren

2007

Experimental Eye Research

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Macular pigment (MP) and melanin possibly protect the macular area by absorbing blue light and acting as antioxidants. Because little is known about the interocular correlation of melanin, we determined its optical density (MOD) in both eyes of healthy subjects using fundus reflectometry. The measuring method also provided optical densities of MP (MPOD). In addition to evaluating its interocular correspondence we checked its dependency on central retinal thickness as measured with optical coherence tomography (OCT). Spectral fundus reflectance was measured in 69 eyes of 37 healthy participants. Both eyes of 32 subjects (15 males and 17 females, aged 57.9 AE 14.6 years) were used to evaluate interocular correspondences. MPOD data from 35 right eyes of 18 males and 17 females, aged 55.7 AE 15.7 years, was used to evaluate the relation between central retinal thickness and MPOD. MOD was 0.99 AE 0.30 (range: 0.57e2.07) for the left eyes and 1.02 AE 0.28 (range: 0.62e2.07) for the right eyes. The intraclass correlation coefficient (ICC) was 0.89 (P < 0.001). MPOD was 0.49 AE 0.19 for the left eyes (range: 0.12e0.81) and 0.47 AE 0.17 (range: 0.14e0.73) for the right eyes. The ICC was 0.91 (P < 0.001). Macular retinal thickness (MRT), representing the average macular thickness in the central 1000 mm zone, was 210 AE 28 mm. Foveal retinal thickness (FRT), representing the retinal thickness at the crossing of the 6 radial scan lines on OCT, was 175 AE 34 mm. Pearson's correlation coefficient showed no significant linear association between MRT and MPOD (r ¼ À0.04, P ¼ 0.82), and between FRT and MPOD (r ¼ 0.05, P ¼ 0.78). The optical density of melanin showed a high interocular correspondence in healthy white participants. Similar results were found for MPOD. Relative interocular differences of more than 32% in MOD, or more than 34% in MPOD, may point to pathology. No relation between central retinal thickness and MPOD was found.

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“…Multimodal confocal scanning laser ophthalmoscopy (cSLO) has recently become increasingly popular, and fundus autofluorescence (FAF), near-infrared reflectance (NIR), and spectral-domain optical coherence tomography (SD-OCT) imaging are noninvasive tests that can be used to visualize the pathological features of the retinal pigment epithelium (RPE), retina, and choroid. 15,16 Although choroidal thickness, measured with SD-OCT, can predict the development of lacquer cracks, 17 other types of topographic fundus imaging such as FAF and NIR, have not yet been used, and the value of these imaging modalities in identifying lacquer cracks remains unknown. Furthermore, whether or not noninvasive multimodal cSLO imaging allows for the detection and characterization of lacquer cracks in highly myopic eyes before an invasive ICGA examination remains unresolved.…”

Section: Introductionmentioning

confidence: 99%

Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

Liu

Lai

et al. 2014

Eye

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Purpose To compare multimodal imaging in detecting lacquer cracks in highly myopic eyes, and to correlate these findings with those of spectral-domain optical coherence tomography (SD-OCT). Methods An observational case series study. Patients with a refractive error worse than À 8 diopters and lacquer cracks were recruited. The rates of detection of the lacquer cracks using multimodal imaging including near-infrared reflectance (NIR) imaging, fundus autofluorescence (FAF) imaging, and fluorescence angiography (FA) were compared. The characteristic findings of multimodal imaging were correlated with those of SD-OCT. Results NIR imaging was more sensitive (92.9%) in detecting lacquer cracks than either FAF (12.5%) or FA (67.9%). Lacquer cracks showed hyperreflectance on NIR, and they were consistently associated with a continuous retinal pigment epitheliumBruch's membrane complex, thinner choroid, and acoustic shadows on SD-OCT. Conclusions NIR imaging is superior to blue laser light (FAF and FA) imaging in detecting lacquer cracks. SD-OCT in combination with NIR located primary pathological lacquer cracks in the intact retinal pigment epithelium-Bruch's membrane complex as well as thinner choroid. These findings indicate that multimodal cSLO and SD-OCT imaging allow for detecting of lacquer cracks in highly myopic eyes.

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Near-Infrared Autofluorescence Imaging of the Fundus: Visualization of Ocular Melanin

Cited by 351 publications

References 44 publications

Lipofuscin- and melanin-related fundus autofluorescence visualize different retinal pigment epithelial alterations in patients with retinitis pigmentosa

Lipofuscin- and melanin-related fundus autofluorescence visualize different retinal pigment epithelial alterations in patients with retinitis pigmentosa

Interocular agreement in melanin and macular pigment optical density

Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

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