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N. Salameh, B. Szirth, N. V. Nayak, A. M. Kolomeyer, A. Khouri, K. S. Shahid, N. Bhagat; Nonmydriatic Retinal Imaging of Lipofuscin in the Assessment of Retinal Health in a Community-Based Screening Program. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1024.
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Lipofuscin, a byproduct of phagocytosed photoreceptor outer segments, accumulates in the retinal pigment epithelium (RPE) with age and in certain retinal diseases. By compromising RPE function, lipofuscin contributes to the pathogenesis of various retinal disorders. Our intent is to investigate whether fundus autofluorescence (FAF) can be used in the early detection of retinal disorders and to correlate those findings by using 3-µm, high-resolution optical coherence tomography (OCT) (Optopol, Poland).
Color, red-free, and FAF imaging was performed for all subjects by using a 15.1 megapixel Canon CX-1 mydriatic and nonmydriatic hybrid retinal camera 1 (Canon Inc, Tokyo, Japan) equipped with a wide-band (530-580 nm) excitation filter and a narrow-band (640 nm) barrier filter. We detected early pathological changes in age-related macular degeneration, retinal dystrophies, macular edema, and toxic maculopathy. OCT was used to confirm and correlate these findings.
FAF was performed on 50 individuals (mean age, 54 years; range, 26-84 years) including 23 males (46%) and 27 females (54%). Of these, 16 (32%) were African American, 16 (32%) were Hispanic, 12 (24%) were Caucasian, three (6%) were South Asian, and three (6%) had another ethnic/racial origin. Eighteen (36%) had a normal fundus, nine (18%) had diabetic retinopathy, five (10%) had glaucoma, four (8%) had nonexudative AMD, four (8%) had exudative AMD, and 10 (20%) had other retinal findings.
FAF digital retinal camera and OCT technology in community-based ocular screenings or a clinical setting may be used to (1) enhance our understanding of retinal disease pathogenesis by tracking temporal changes in lipofuscin distribution in the fundus; (2) allow earlier diagnosis of certain retinal disorders, which may be related to lipofuscin accumulation; (3) permit assessment of risk factors that may affect lipofuscin accumulation in the fundus; and (4) aid in differentiating diseases with similar lipofuscin accumulation signatures.
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