June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
The impact of lens autofluorescence and opacification on fundus autofluorescence imaging.
Author Affiliations & Notes
  • Thomas Ach
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Geena Rennen
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Maximilian Pfau
    National Eye Institute, National Institutes of Health, Maryland, United States
  • Marlene Sassmannshausen
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Frank G Holz
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Leon Alexander von der Emde
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Footnotes
    Commercial Relationships   Thomas Ach Roche, Novartis, Heidelberg Engineering, Code C (Consultant/Contractor), Macregen, Code I (Personal Financial Interest), Novartis, Nidek, Code R (Recipient); Geena Rennen None; Maximilian Pfau Apellis Pharmaceuticals , Code C (Consultant/Contractor); Marlene Sassmannshausen Heidelberg Engineering, CenterVue, Carl Zeiss MedicTec, Code F (Financial Support); Frank Holz Acucela, Apellis, Bayer, Boehringer-Ingelheim, Bioeq/Formycon, Roche/Genentech, Geuder, Graybug, Gyroscope, Heidelberg Engineering, IvericBio, Kanghong, LinBioscience, Novartis, Oxurion, Pixium Vision, Oxurion, Stealth BioTherapeutics, Zeiss, Code C (Consultant/Contractor), Acucela, Allergan, Apellis, Bayer, Bioeq/Formycon, CenterVue, Ellex, Roche/Genentech, Geuder, Heidelberg Engineering, IvericBio, Kanghong, NightStarX, Novartis, Optos, Pixium Vision, Zeiss, Code F (Financial Support); Leon von der Emde None
  • Footnotes
    Support  NIH Grant 1R01EY027948-01 (TA)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 232 – F0079. doi:
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      Thomas Ach, Geena Rennen, Maximilian Pfau, Marlene Sassmannshausen, Frank G Holz, Leon Alexander von der Emde; The impact of lens autofluorescence and opacification on fundus autofluorescence imaging.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):232 – F0079.

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

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Purpose : Quantitative and qualitative fundus autofluorescence (FAF) analysis strongly depends on the clearness of the optical media. Especially the lens status is crucial in FAF imaging since the aging lens has both light blocking and AF properties that impact and distort image analysis. Here, we report both lens opacification and lens autofluorescence (LAF) to aid the development of a lens correction factor for adequate FAF analysis.

Methods : Seventy-four subjects (18-95 years, mean of 9.2 +/- 4.1 per decade, 28 females) received quantitative LAF (using laser scanning ophthalmoscope), Scheimpflug, as well as blue FAF, green FAF, and infrared (IR) imaging. LAF values were determined following the protocol as recently proposed (PMID: 28973367). The Pentacam nucleus staging (PNS) score was extracted from Scheimpflug images to estimate lens opacification. Mean opinion scores (MOS) of FAF and IR image quality (focus, illumination, symmetry, zoom, centering) were compiled by two medical readers. Linear regression analyses between PNS/LAF and age were calculated, and the coefficient of determination (r2) was reported. Finally, a Pearson’s correlation coefficient (r) between PNS/LAF and the respective MOS was determined.

Results : Mean LAF for the third and seventh life decade were 4.2 +/- 2.1 and 13.5 +/- 7.2 [a.u]. Both PNS and LAF showed a significant age-dependent increase (p < 0.01) with an r2 of 0.28/0.38. LAF was associated with a significantly reduced MOS (p=0.04) only for blue FAF with an r of 0.2. Similarly, PNS was associated with a reduced MOS (p= 0.02) for blue FAF with an r of 0.3.

Conclusions : Age only explained a limited fraction of the variability in both lenticular autofluorescence and opacification. Retinal image quality, especially in the shorter wavelengths, deteriorated slightly with lenticular remodeling. These results question the current practice of simple age-based opacification correction in quantitative FAF imaging. Individualized measures of lens remodeling have the potential to characterize the influence of the optical media more precisely. We propose LAF and PNS as novel methods to correct for lenticular autofluorescence and opacification.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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