July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Quantified fundus autofluorescence (QAF) in healthy children and adolescents
Author Affiliations & Notes
  • Carla Pröbster
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • Ioana-Sandra Tarau
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • Nikolai Kleefeldt
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • Jost Hillenkamp
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • Martin M. Nentwich
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • KENNETH R SLOAN
    Dept of Ophthalmology, University of Alabama at Birmingham, Alabama, United States
  • Thomas Ach
    Dept of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany
  • Footnotes
    Commercial Relationships   Carla Pröbster, None; Ioana-Sandra Tarau, None; Nikolai Kleefeldt, None; Jost Hillenkamp, None; Martin M. Nentwich, None; KENNETH SLOAN, None; Thomas Ach, Alimera (R), Allergan (R), Roche (C)
  • Footnotes
    Support  NIH R01EY027948 (TA)
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1600. doi:
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      Carla Pröbster, Ioana-Sandra Tarau, Nikolai Kleefeldt, Jost Hillenkamp, Martin M. Nentwich, KENNETH R SLOAN, Thomas Ach; Quantified fundus autofluorescence (QAF) in healthy children and adolescents. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1600.

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

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Abstract

Purpose : QAF is a relatively new imaging modality (PMID: 22016060) which uses an internal reference to compare fundus autofluorescence (AF) intensities between subjects and in longitudinal follow-up settings. Only few data exist on AF in the young eye. Here, QAF of children and young adolescent in a large cohort are reported.

Methods : After written consent, 50 healthy children (5-17 years, Caucasians, clear media) underwent multimodal imaging (infrared, AF (488, 787nm), QAF (488nm) and spectral-domain optical coherence tomography (SD-OCT)) using Spectralis/modified HRA2 (Heidelberg Engineering). Custom written FIJI plugins enabled: 1. determination of the fovea in SD-OCT/infrared images, 2. alignment and superimposition of multimodal retina images based on foveal position, 3. post-QAF-acquisition adjustments to the internal reference and the age-related optical media density, and 4. building of standard QAF retina maps (QAF intensities for each pixel at a certain distance and direction from the fovea) for two age groups (5-10, 11-17 years). Also, mean QAF8 values ±standard deviation (PMID: 23860757) are reported.

Results : 50 subjects (24 (5-10 yrs), 26 (11-17 yrs)) were multimodally imaged and all images were matched on foveal position. Interestingly, highest QAF-values are found at the perifovea with maxima at the temporal-superior regions, even in the youngest subjects examined (5 yrs, figure). With further development, there is an increase of QAF intensities throughout the posterior pole with a significant increase in mean QAF8 between first and second decade (mean QAF8 (5-10 yrs): 89.1 ±23.0; (11-17 yrs): 125.3 ±24.5, arbitrary units; p<0.001). However, the QAF values at the fovea remain low.

Conclusions : This is the largest report on QAF in the maturing eye so far. Of interest, as in adults, the typical AF pattern of highest QAF values temporal-superior to the fovea (PMID: 669891, 25034602) is visible very early in life, which might reflect so far unknown metabolic processes in the rod-rich region. The standard retinas are pre-requisite to distinguish pathological AF signals in diseased eyes, currently evaluated in ongoing studies.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

QAF in childhood. At age 5 years, QAF values are low. A region of high AF is apparent temporal to the fovea. QAF increases markedly in the second decade (11, 15 years). QAF at the fovea is blocked due to macular pigment and high density of RPE melanosomes. [a.u.] = arbitrary units.

QAF in childhood. At age 5 years, QAF values are low. A region of high AF is apparent temporal to the fovea. QAF increases markedly in the second decade (11, 15 years). QAF at the fovea is blocked due to macular pigment and high density of RPE melanosomes. [a.u.] = arbitrary units.

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