September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Monitoring macular pigment in geographic atrophy using FLIO
Author Affiliations & Notes
  • Lydia Sauer
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Sven Peters
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Johanna Schmidt
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Dietrich Schweitzer
    Ophthalmology & Visual Science, Technische Universitaet Ilmenau, Ilmenau, Germany
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Matthias Klemm
    Ophthalmology & Visual Science, Technische Universitaet Ilmenau, Ilmenau, Germany
  • Regine Augsten
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Daniel Meller
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Martin Hammer
    Department of Ophthalmology, University Hospital Jena, Jena, Germany
  • Footnotes
    Commercial Relationships   Lydia Sauer, None; Sven Peters, None; Johanna Schmidt, None; Dietrich Schweitzer, None; Matthias Klemm, None; Regine Augsten, None; Daniel Meller, None; Martin Hammer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1707. doi:
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    • Get Citation

      Lydia Sauer, Sven Peters, Johanna Schmidt, Dietrich Schweitzer, Matthias Klemm, Regine Augsten, Daniel Meller, Martin Hammer; Monitoring macular pigment in geographic atrophy using FLIO. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1707.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : The pathophysiology of geographic atrophy (GA) is not yet fully understood and prognostic factors are still under discussion. Little is known about how the macular pigment (MP) changes during the progress of the disease. Monitoring fundus autofluorescence (FAF) lifetimes in GA using Fluorescence-lifetime-Imaging-Ophthalmoscopy (FLIO) may lead to novel insights, especially since FLIO can detect MP.

Methods : Using FLIO (Heidelberg-Engineering, Heidelberg, Germany), time-resolved FAF of 20 eyes with GA has been recorded in two spectral channels (ch1: 498-560nm; ch2: 560-720nm) and approximated by a series of three exponentials, resulting in three lifetimes: (τ1-τ3). Their amplitude-weighted mean (τm) per channel and pixel was utilized as the main parameter for statistical analysis. A FAF image was acquired with each measurement; OCT scans and fundus photography were obtained.
τm was averaged over the standardized ETDRS grid and the area of the fovea (diameter 0,1mm). Of special interest were differences between the fovea and the Inner Ring (IR) of the grid. These differences (τm (IR) minus τm (fovea)) were correlated to the best corrected visual acuity (BCVA).

Results : Mean FAF lifetimes in GA differ according to the individual progression of the disease. Additionally to hypo- and hyperfluorescent regions detectable with FAF, FLIO visualizes differences within these regions: The presence of MP results in shorter FAF lifetimes (250-400 ps) compared to other atrophic regions (>700 ps) (figure 1). These short FAF decays are often related to a spared fovea.
The τm differences between the IR and the Fovea (τm (IR) minus τm (fovea)) correlate with the BCVA (r:0.6; p<0.01 for both channels).

Conclusions : Whereas conventional FAF images only show differences in the fluorescence intensity, FLIO can additionally distinguish between different atrophic areas, better showing the presence of MP, resulting in different lifetimes and possibly detecting spared regions.
FLIO is a new imaging method to monitor GA. If FLIO can provide information on the GA progression needs to be further evaluated.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1: FAF intensity (A) and lifetime (B) image of one eye with geographic atrophy. Differences in τm of the atrophic area are visible with high contrast.

Figure 1: FAF intensity (A) and lifetime (B) image of one eye with geographic atrophy. Differences in τm of the atrophic area are visible with high contrast.

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