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Jorge Santiago Andrade Romo, Maria V. Castanos Toral, Davis B Zhou, Douglas F Buxton, Richard Rosen; Flavoprotein Fluorescence Changes in the Retina with Cataract Surgery.. Invest. Ophthalmol. Vis. Sci. 2019;60(11):PB0184.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the impact of cataract surgery on retinal metabolism using flavoprotein fluorescence (FPF) monitoring.
Nine subjects (non-diabetics) were included in the study. Retinal metabolic analysis was performed pre and post cataract surgery using the OcuMet Beacon (Ocusciences, Ann Arbor, MI). It features a customized fundus camera with 467 nm excitation and 535 nm emission filters and a back-illuminated electron multiplying charge-coupled camera. The depth of focus enables capture of FPF values from all layers of the retina in a central 13° diameter circular region of interest (ROI) centered at the fovea (Fig). Patients were imaged immediately prior to surgery and post-operatively at an interval range of 31-103 days. During each imaging session, four scans were acquired to generate an average raw FPF value in gray scale units (gsu). Scans were also processed to compensate for the influence of cataracts or IOLs, providing adjusted FPF measurements (lens FPF and retinal FPF). Color-coded maps were then obtained for the ROI, with warmer colors indicating greater mitochondrial oxidative stress (Fig). Paired sample t-test was used to analyze differences between the pre-op and post-op FPF values.
Mean raw FPF, lens FPF, and retinal FPF values before surgery were 455, 426, and 29gsu, respectively; and following surgery were 186, 112, and 74gsu. All FPF values were significantly different before and after surgery (p<0.010).
Flavoprotein fluorescence (FPF) analysis mirrors fluctuations in retinal metabolic stress induced by cataract surgery. A clearer picture of the complexities of blue light penetration through the lens will be necessary to better quantify the contribution of elevated mitochondrial stress in the increase of FPF before it can become a useful clinical tool.
This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.
Figure: Before and after cataract surgery images from a single subject. A1, B1) SLO retinal image with ROI (green circle). A2) Pre-op raw FPF color map, warm hue is present (high fluorescence from cataract) (raw FPF: 758gsu). B2) Post-op raw FPF, a cooler hue is present (lower fluorescence from IOL) (raw FPF: 480gsu). A3) Pre-op retinal FPF color map, faint blue hue speckled pattern (retinal FPF: 36gsu). B3) Post-op retinal FPF color map, more uniform and intense blue (retinal FPF: 94gsu). SLO: scanning laser ophthalmoscopy, FPF: flavoprotein fluorescence, gsu: gray scale units.
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