Purchase this article with an account.
Martin Gliem, Philipp Mueller, Frank G Holz, Peter Charbel Issa; Quantitative fundus autofluorescence in age-related macular degeneration and other retinal diseases associated with drusen. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5931.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Lipofuscin accumulation in the retinal pigment epithelium (RPE) has been suggested to play a pathophysiological role in various monogenetic and complex retinal diseases including age-related macular degeneration (AMD) with direct evidence for this assumption in Stargardt disease. The aim of this study was to quantitatively measure lipofuscin-related fundus autofluorescence (AF) in early or intermediate AMD and other retinal diseases associated with drusen.
Fundus AF images were acquired with a modified scanning laser ophthalmoscope equipped with an internal fluorescent reference (modified Spectralis HRA-OCT, Heidelberg Engineering, Heidelberg, Germany). All patients were younger than 65 years of age. The disease spectrum included early or intermediate AMD, reticular pseudodrusen with or without geographic atrophy (GA), basal laminar drusen (BLD), colloidal drusen and membranoproliferative glomerulonephritis (MPGN) type 2. For every subject, the mean gray value of a defined circular region at an eccentricity of approximately 7° to 9° centered on the fovea was determined. The quantitative AF (qAF) value was calculated after adjustment to the reference, the optical magnification, the density of the ocular media, the laser offset and a device-specific correction factor. Data was compared to normative qAF values derived from 90 healthy subjects.
Thirty-nine patients were investigated. Mean±SD age was 52±6 years (range: 35-61 years). All patients with early and intermediate AMD (n=7) revealed qAF levels within the 95% confidence interval (CI) of age-matched controls. In patients with BLD (n=11), colloidal drusen (n=3) and RPD without GA (n=12), qAF levels were within the 95% CI in 91%, 67% and 75%, respectively. The remaining patients of these groups as well as all patients with GA (n=4) and the patient with MPGN type 2 (n=1) had qAF values below the age-matched 95% CI. No patient showed a qAF value above the age-matched 95% CI.
QAF measurements showed no increased lipofuscin-related fundus-AF in early or intermediate AMD or other diseases associated with drusen which may serve as model diseases for AMD. Lower qAF-levels in certain subgroups may point to subnormal lipofuscin concentration in the RPE or disease-specific limitations to detect true RPE lipofuscin content.
This PDF is available to Subscribers Only