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Mirela R. tabacaru, Tobias Duncker, Jonathan P. Greenberg, Stephen H. Tsang, Ronald E. Carr, Vivienne C. Greenstein; A Comparison of the Regions of Increased Autofluorescence Obtained with Near-infrared Autofluorescence and Fundus Autofluorescence in Patients with Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4576.
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To compare melanin-related near-infrared autofluorescence (NIR-AF)with lipofuscin-related autofluorescence (FAF), and assess their relationship to the underlying retinal structure in patients with retinitis pigmentosa (RP).
Twelve eyes from 9 patients with RP (autosomal recessive=3, autosomal dominant=1, Usher syndrome type I=2, Usher syndrome type II=3), with ages 7 to 54 years and BCVAs 20/20 to 20/40, were analyzed. For each patient, a horizontal line scan through the fovea was obtained with the Spectralis SLO-OCT (Heidelberg Eng.) and was automatically registered with an FAF (488 nm) image in real time. NIR-AF (787 nm) SLO imaging was performed with the Heidelberg Retina Angiograph 2 (Heidelberg Eng.) and the image was aligned with the FAF image using Matlab software. For 5 eyes, the images were manually registered in Photoshop. The boundaries of the hyperautofluorescent rings seen on NIR-AF and FAF images were compared to the location where the inner segment ellipsoid (ISe) band was not visible.
All eyes showed a ring of increased autofluorescence in the same region on both FAF and NIR-AF, but the diameter of the ring was more constricted on NIR-AF than FAF.The outer border of the ring was more distinct on NIR-AF than FAF. Outside the ring, an abrupt decline in intensity was evident on NIR-AF. The inner border of the ring was visualized in all eyes on FAF, however it was less visible in 4 eyes on NIR-AF. On SD-OCT, loss of the ISe band corresponded to the inner border of the ring on both FAF and NIR-AF images, or to an area located within the hyperautofluorescent zone of the ring in the 4 eyes where the inner border was not clear on NIR-AF.
A distinct hyperautofluoscent ring is seen on both FAF and NIR-AF. Because the diameter of the ring on NIR-AF correlates with the length of the ISe band seen on SD-OCT and displays a sharply defined outer border, NIR-AF may be a useful tool for monitoring disease progression in RP patients. NIR-AF imaging has an additional merit of being more patient-friendly and not requiring pupil mydriasis. The differences between the NIR-AF and FAF images also provide additional information about the pathophysiological mechanisms in RP.
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