March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Autofluorescence and Reflectance Imaging of Macular Laser Scars
Author Affiliations & Notes
  • Ankur Raj
    University of Liverpool, Department of Eye & Vision Science, Liverpool, United Kingdom
    Royal Liverpool University Hospital, St Paul's Eye Unit, Liverpool, United Kingdom
  • Simon Harding
    University of Liverpool, Department of Eye & Vision Science, Liverpool, United Kingdom
    Royal Liverpool University Hospital, St Paul's Eye Unit, Liverpool, United Kingdom
  • Jayashree Sahni
    University of Liverpool, Department of Eye & Vision Science, Liverpool, United Kingdom
    Royal Liverpool University Hospital, St Paul's Eye Unit, Liverpool, United Kingdom
  • Footnotes
    Commercial Relationships  Ankur Raj, None; Simon Harding, None; Jayashree Sahni, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2688. doi:https://doi.org/
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      Ankur Raj, Simon Harding, Jayashree Sahni; Autofluorescence and Reflectance Imaging of Macular Laser Scars. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2688. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

SW-AF has been suggested as being useful in identifying laser scars in the diabetic macula. We compared short wave autofluorescence (SW-AF) and near infra-red reflectance (NIR-RF) imaging for the identification of scars in diabetic macular oedema (DMO).

 
Methods:
 

Patients with a history of macular laser for DMO underwent imaging using SW-AF (excitation 488nm, detection >500nm), NIR-RF (emission 820nm) and NIR-AF (excitation 788nm, detection >820nm) using a Heidelberg HRA2 scanning laser ophthalmoscope (SLO). Images were graded by two medical retina specialists (AR, JS) for visibility and proportion of border that is delineated: 0 (none visible), 1 (<50% border delineated), 2 (50-90%), 3 (>90%). Mann-Whitney U and Kappa analysis was performed using SPSS version 19.

 
Results:
 

18 eyes of 17 patients were included. The appearance of laser scar was as follows: on SW-AF a focus of hyperfluorescence with a surrounding ring of hypofluorescence (Fig 1a); on NIR-RF a focus of hyper-reflectance, occasionally surrounded by a ring of hyporeflectance (Fig 1b); and on NIR-AF a focus of hypofluorescence with an occasional central spot of hyperfluorescence (Fig 1c). Agreement between graders was good: same grade assigned 85%; within 1 grade 100% (Κ = 0.722). 3 eyes (16.7%) did not demonstrate laser scars on SW-AF; these were visible in all on NIR-RF and NIR-AF. Although NIR-RF and NIR-AF provided clearer imaging of laser scars as compared to SW-AF, the difference did not reach statistical significance (p=0.19 and 0.45 respectively). Reflectance was easier to collect in most subjects.

 
Conclusions:
 

SLO based NIR techniques appear to be useful in detecting laser scars in the assessment of diabetic maculopathy. Based on the experience of our subjects, reflectance may be preferable to autofluorescence.  

 
Keywords: laser • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • diabetes 
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