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François C. Delori, Mark R. Fleckner, Douglas G. Goger, John J. Weiter, C. Kathleen Dorey; Autofluorescence Distribution Associated with Drusen in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2000;41(2):496-504.
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purpose. To determine whether drusen in patients with age-related maculopathy
and macular degeneration (ARM/AMD) are associated with focal changes in
retinal pigment epithelium (RPE) lipofuscin fluorescence.
methods. A new autofluorescence imaging device was used to study lipofuscin
distribution associated with individual drusen in 20 patients with
ARM/AMD. Paired monochromatic and autofluorescence fundus images were
used for detailed analysis of the topography of autofluorescence at
specific sites containing drusen. In four eyes, image analysis was used
to compare the spatial distribution of the autofluorescence with the
location of drusen and to quantify the autofluorescence distribution
over individual drusen (54 drusen).
results. A specific pattern of autofluorescence was frequently found to be
spatially associated with hard drusen and soft drusen between 60 and
175 μm in size. The pattern is characterized by a central area of
decreased autofluorescence surrounded, in most cases, by an annulus of
increased autofluorescence. The location of this pattern was highly
correlated with the position of individual distinct drusen. The central
low autofluorescence focus was on average 16% below the surrounding
background, and the annulus, when present, was on average 6% more
fluorescent than the background. Soft drusen larger than 175 μm and
confluent soft drusen show either multifocal areas of low
autofluorescence or a more heterogeneous distribution.
conclusions. Autofluorescence imaging permits measurement of RPE lipofuscin at
specific sites. RPE overlying drusen have altered autofluorescence,
suggesting changes in RPE health.
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