April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
Absolute Autofluorescence (AbsAF) in Stargardt Disease (STGD)
Author Affiliations & Notes
  • T. R. Burke
    Ophthalmology, Columbia University, New York, New York
  • S. H. Tsang
    Ophthalmology, Columbia University, New York, New York
  • J. P. Greenberg
    Ophthalmology, Columbia University, New York, New York
  • T. Duncker
    Ophthalmology, Columbia University, New York, New York
  • J. R. Sparrow
    Ophthalmology, Columbia University, New York, New York
  • G. R. Barile
    Ophthalmology, Columbia University, New York, New York
  • F. C. Delori
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
  • T. Smith
    Ophthalmology, Columbia University, New York, New York
  • Footnotes
    Commercial Relationships  T.R. Burke, None; S.H. Tsang, None; J.P. Greenberg, None; T. Duncker, None; J.R. Sparrow, None; G.R. Barile, None; F.C. Delori, None; T. Smith, None.
  • Footnotes
    Support  New York Community Trust, NEI R01 EY015520, R01EY018213 (SHT), Foundation Fighting Blindness, Bernard Becker-Association of University Professors in Ophthalmology-Research to Prevent Blindness Award
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4054. doi:
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    • Get Citation

      T. R. Burke, S. H. Tsang, J. P. Greenberg, T. Duncker, J. R. Sparrow, G. R. Barile, F. C. Delori, T. Smith; Absolute Autofluorescence (AbsAF) in Stargardt Disease (STGD). Invest. Ophthalmol. Vis. Sci. 2010;51(13):4054.

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

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To demonstrate AbsAF levels in patients with STGD can correlate with in vivo lipofuscin levels.


AbsAF measurements were done on 22 patients with STGD (ages 10 to 67 yrs, 37 eyes) using the HRA2 (Heidelberg Engineering Inc., Vista, CA) modified by insertion of a fluorescence reference chip in a retinal image plane (Fig 1). Correction was made for refractive error and optical media density from normative data.


Median AbsAF values in the central 3000 micron diameter region as well as superior and temporal macular regions were compared to the data from age matched controls.The internal fluorescence reference (horizontal strip) is at the top of each image. The AbsAF images are generated by Matlab using the formula in Fig 2 - SC is the refractive error correction and (T-1om,488T-1om,emi) is the optical media density correction. The zero (GL0) is calculated from darkest pixels, usually at the optic disc. The reference gray level (GLR) is measured from the original AF images. Two tailed t-test was used for analysis.Results: Excluding 10 eyes of 6 patients where atrophy or poor centration precluded imaging of focal macular hyperfluorescence, background levels of AbsAF were found to be significantly elevated relative to controls (Table 1, Chart 1) and levels 400% greater were detected in flecks compared with background AbsAF in STGD patients (mean fleck: 159.7, mean background: 94.5, p<0.003), while areas in the transition zone from hyper to hypofluorescence (atrophy) demonstrate levels double the highest background levels in STGD.


Absolute AF measurements in STGD can shed quantitative light on the disease process which is not possible with previous in vivo imaging techniques. This will not only help with monitoring disease progression, but will be a useful marker of individual mutation effect and of response to interventional therapies in the future. Our patients demonstrate a markedly increased level of AbsAF in youth, but tapering with age as atrophy of the pigment epithelium ensues. Flecks and transition zones show the highest AbsAF.  

Keywords: retinal degenerations: hereditary • imaging/image analysis: clinical • retina 

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