There are two different digital technologies currently used to capture fundus autofluorescence images. Interpretations of fundus autofluorescence from studies of. Fundus autofluorescence imaging is used to record fluorescence that may occur naturally in ocular structures or as a byproduct of a disease process. Methods 10 normal volunteers and 10 patients with retinal disease were included in the study. Fundus autofluorescence imaging is a novel imaging method that allows topographic mapping of lipofuscin distribution in the retinal pigment epithelium cell monolayer as well as of other fluorophores that may occur with disease in the outer retina and the subneurosensory space. During the last decade, fundus autofluorescence faf imaging of the retina has emerged as a useful, noninvasive imaging technique in the diagnosis and followup of several retinal dystrophies robson et al. The tale of fundus autofluorescence imaging as one of professional eye cares most versatile diagnostic screening techniques, fundus autofluorescence imaging has helped to preserve the vision of several thousand patients throughout its relatively short existence. We report the first case in the literature of chorioretinal atrophy involving the macula in an 11yearold girl. The basic science chapters explain the synthesis and degradation of lipofuscin, the main fluorophore in the retina generating the fundus autofluorescence signal. Jerome sherman posted on may 21, 20 by optos in addition to developing instruments and devices that equip optometrists and ophthalmologists with better diagnostic capabilities, we also strive to help educate practitioners by offering clinical trainings designed to provide information on the. March 2009 meena chakrabarti fundus autofluorescence imaging 57 decreased fundus autofluorescence with progressively decreasing fundus autofluorescence from the centre of the lesion toward the surrounding background fluorescence. Simultaneous spectral domain oct and fundus autofluorescence. The nuts and bolts of fundus autofluorescence imaging. Clinical applications of fundus autofluorescence in retinal disease madeline yung 1, michael a.
Ophthalmic imaging technology has revolutionized fundus examination. The effects of gain and noise in fundus autofluorescence imaging. T1 application of ratiometry to fundus autofluorescence imaging. Lack of fundus autofluorescence to 488 nanometers from childhood on in patients with earlyonset severe retinal dystrophy associated with mutations in rpe65. Methods simultaneous sdoct and faf imaging were performed using a combined sdoct. Twophoton excited fluorescence microscopy of ocular fundus for the interpretation of fundus autofluorescence analysis in vivo s. Automated analysis of digital fundus autofluorescence. Fundus autofluorescence faf is an imaging method using a specific wavelength of light to trigger the fundus fluorescent characteristics without the need of contrast 7,15.
Klufas1 and david sarraf1,2 abstract fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. With the introduction of fluorescein angiography decades ago, ophthalmologists observed that, even without the use of fluorescein, parts of the fundus showed areas of fluorescence in certain conditions. This pattern is associated with cluster of small soft drusen, hard drusen and areas of pigmentary changes fig. Fundus autofluorescence faf is a novel noninvasive imaging technique providing invivo information on retinal status. Each chapter also points out the value of fundus autofluorescence findings in understanding the pathogenesis of the condition, and provides a. Clinical applications of fundus autofluorescence in retinal disease.
Autofluorescence imaging of the retina overview fundus autofluorescence is a vital tool that can be used to evaluate a variety of retinal diseases that involve abnormal fluorophore accumulation or the loss of fluorophores. The autofluorescence of the fundus can be excited across a broad range of wavelengths. Autofluorescence imaging of lipofuscin first became practical with the implementation of confocal scanning laser technology. Fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular. Another important recent innovation in faf imaging is the adaptation of widefield fundus imaging systems, such as the optos 200tx, to perform autofluoresence imaging. A test tool was implemented that uses regiongrowing. Lorenz b, wabbels b, wegscheider e, hamel cp, drexler w, preising mn. Fundus autofluorescence imaging may allow identification of additional information on the status of the retinal pigment epithelium and may expand the spectrum of possible risk factors, the.
The imagej software was used to determine the gray level corresponding to the darkest veins and the peripapillary ring thresholds, the level of white of the brightest perifoveal area, their difference contrast level, and the suprathreshold. We are applying ratiometric analysis to fundus autofluorescence imaging as a means for early diagnosis of this disease. To describe clinical, optical coherence tomography oct and fundus autofluorescence faf findings in. Agerelated macular degeneration is the leading cause of blindness in the u. Excessive accumulation of lipofuscin granules in the lysosomal compartment of retinal pigment epithelium cells. Spaide, md, in private practice with vitreousretinamacula consultants of new york.
Atlas of fundus autofluorscence imaging springerlink. All the clinical cases gathered in this atlas have been collected by a group of retina specialists who have found in eidon a useful tool to support their clinical activities. Although this faint, socalled autofluorescence was at first considered. Pdf fundus autofluorescence features in the inflammatory. These fluorophores are endogenous, thereafter there is no need to inject any dye to acquire faf images. Fundus autofluorescence applications in retinal imaging. Added value of infrared, redfree and autofluorescence. Fundus autofluorescence imaging of retinal dystrophies. Aug 12, 2010 in the corresponding fundus autofluorescence image right, atrophic patches are clearly delineated by decreased intensity and high contrast to nonatrophic retina.
Autofluorescence, fluorangiography, correlated to the fundus imaging, that time by time may support or improve the diagnostic process. Methods simultaneous sdoct and faf imaging were performed. Retromode imaging and fundus autofluorescence with scanning laser ophthalmoscope of retinal dystrophies battaglia parodi maurizio1, iacono pierluigi2, kontadakis stelios1, vergallo stefano3, cascavilla marialucia1, zucchiatti ilaria1 and bandello francesco1 abstract. Research article open access retromode imaging and fundus autofluorescence with scanning laser ophthalmoscope of retinal dystrophies battaglia parodi maurizio1, iacono pierluigi2, kontadakis stelios1, vergallo stefano3, cascavilla marialucia1, zucchiatti ilaria1 and bandello francesco1 abstract.
Fundus autofluorescence faf imaging is based on the fluorescence from ocular endogenous fluorophores located in the retinal. Full text spotlight on fundus autofluorescence opto. However, the phenotype, including the ophthalmological manifestations, varies in severity. To compare the autofluorescence images of the zeiss versus topcon eye fundus cameras and design an objective way to quantify it. The role of fundus autofluorescence imaging in the study of. Clinical applications of fundus autofluorescence in retinal. Autofluorescence images with carl zeiss versus topcon eye. Mar 24, 2014 fundus autofluorescence imaging is used to record fluorescence that may occur naturally in ocular structures or as a byproduct of a disease process. The present study aims to evaluate the added value of novel funduscopic imaging techniques, such as nearinfrared. Fundus autofluorescence ophthalmic photographers society. With the advent of confocal scanning laser ophthalmoscopes cslo, fundus autofluorescence faf resulting mainly from lipofuscin accumulation. Fundus autofluorescence imaging grade reading center. Aim to evaluate the reproducibility of the background fundus autofluorescence measurements obtained using a confocal scanning laser ophthalmoscope. Automated analysis of digital fundus autofluorescence images.
The role of fundus autofluorescence imaging in the study. Bennett, cra, octc, fops penn state hershey eye center hershey, pennsylvania. Although it is an slo system, the optos faf acquires images using green light, similar to flashcamera faf. Jul 20, 2012 optical coherence tomography and fundus autofluorescence imaging study of chorioretinal atrophy involving the macula in alagille syndrome shinji makino, yuko ohkubo, hironobu tampodepartment of ophthalmology, jichi medical university, shimotsuke, tochigi, japanabstract. Pdf fundus autofluorescence in agerelated macular degeneration. Dawczynski 2 1 university hospital jena, department of exp. During recent years, faf fundus autofluorescence imaging has been shown to. Fundus autofluorescence faf is a noninvasive imaging technique that enables the visualization of lipofuscin changes in the retinal pigment epithelium. Five images of the same eye of each individual were obtained, after pupillary. The laser delivers a very narrow wavelength band allowing for efficient excitation of fluorescence. This study aims to illustrate the spectrum of faf changes in a variety of retinal dystrophies.
Fundus autofluorescence brittany bateman, bs fundus autofluorescence 2 fundus autofluorescence imaging is used to record fluorescence that may occur naturally in ocular structures or as a byproduct of a disease process. In the corresponding fundus autofluorescence image right, atrophic patches are clearly delineated by decreased intensity and high contrast to nonatrophic retina. Twophoton excited fluorescence microscopy of ocular fundus. Fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the. We report the first case in the literature of chorioretinal atrophy involving the macula in an 11yearold girl with alagille. Fundus autofluorescence in patients with leber congenital amaurosis. Quantitative fundus autofluorescence in recessive stargardt disease. Reproducibility of fundus autofluorescence measurements. For decades, fundus cameras equipped with excitation and barrier filters for fluorescein angiography have occasionally been used to document highly fluorescent ocular structures such as optic nerve drusen with high iso film or monochrome digital sensors. Research article open access retromode imaging and.
Faf imaging represents one of various novel tools and provides information over and above fundus photography, fluorescence angiography and optical coherence tomography. Aug 18, 2014 fundus autofluorescence imaging may allow identification of additional information on the status of the retinal pigment epithelium and may expand the spectrum of possible risk factors, the. Increased fundus autofluorescence and progression of geographic atrophy secondary to agerelated macular degeneration. Featuring over 250 illustrations, this detailed fullcolor textbook provides uptodate information on the use of fundus autofluorescence imaging in the evaluation of retinal disease. Backgroundaims to evaluate the ultrastructural changes in the macula after successful repair of rhegmatogenous retinal detachment rrd using simultaneous spectral domain optical coherence tomography sdoct and fundus autofluorescence faf imaging and to perform functional correlations with microperimetry. An accessible imaging method autofluorescence imaging is most commonly obtained with scanning laser ophthalmoscopic slo systems, but they can also be effectively accomplished with fundus photography if the camera is outfitted with special filters to offset interference from the crystalline lens. Autofluorescence imaging is most commonly obtained with scanning laser ophthalmoscopic slo systems, but optimized filters for fundus autofluorescence imaging new filters minimize noise and improve image contrast. Ocular autofluorescence more than just the fundus eyepix. Optical coherence tomography and fundus autofluorescence imaging study of chorioretinal atrophy involving the macula in alagille syndrome shinji makino, yuko ohkubo, hironobu tampodepartment of ophthalmology, jichi medical university, shimotsuke, tochigi, japanabstract. Fundus autofluorescence faf imaging and threedimensional 3d heat maps demonstrating range of foveal autofluorescence. Interventional case series including 23 eyes of 15 patients with diagnosis of a specific type of retinochoroiditis, such as acute posterior multifocal placoid pigment epitheliopathy apmppe, serpiginouslike. Fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Optical coherence tomography and fundus autofluorescence. Autofluorescence was shown to be abnormally high in certain.
Five images of the same eye of each individual were obtained, after pupillary dilatation, by two investigators. Fundus autofluorescence faf imaging is a novel imaging method that allows topographic mapping of lipofuscin distribution in the retinal pigment epithelium cell monolayer as well as of other fluorophores that may occur with disease in the outer retina and the subneurosensory space. Pseudoxanthoma elasticum pxe is an autosomal recessive disorder caused by mutations in the abcc6 gene and primarily affects the oculocutaneous and cardiovascular systems. Fundus autofluorescence imaging in agerelated macular degeneration using confocal scanning laser ophthalmoscopy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultrawidefield imaging device, are available to the. Autofluorescence imaging allows for earlier diagnosis of. The aim of this study is to determine the fluorescence emission spectra and lifetimes of endogenous fluorophores in ex vivo porcine ocular fundus samples by means of twophoton excited fluorescence spectrum and lifetime imaging microscopy fsimflim. Clinical, optical coherence tomography, and fundus. The cslo was used to image the distribution of lipofuscin in the retinal pigment epithelium in vivo. Obtaining sufficientquality faf images generally becomes. Principle of autofluorescence imaging and interpretation of faf images.
Atlas of fundus autofluorescence imaging by loretta. To describe clinical, optical coherence tomography oct and fundus autofluorescence faf findings in patients. Asymmetrical fundus autofluorescence findings in parkinsons disease j ophthalmol asymmetrical fundus autofluorescence findings in parkinsons disease umur k1 and melike ozgun g2 1department of. Jul 01, 2009 the authors discuss the clinical utility of fundus autofluorescence in the context of other imaging techniques, such as fluorescein and indocyanine green angiography and optical coherence tomography. How to read fluorescein angiography volume 2 issue 4 2015 yazan zahran ophthalmologist, yazan zahran eye clinic, jordan. Hereby, faf imaging gives additional information above. Our study suggests that imaging of the retina early in the disease by faf may reveal findings consistent with the asymmetric nature of pd. Fundus autofluorescence af imaging using confocal scanning laser ophthalmoscopy cslo provides an accurate delineation of areas of geographic atrophy ga. Comparing rod and cone function with fundus autofluorescence images in retinitis pigmentosa. Fundus photo autofluorescence imaging long version.
Fundus autofluorescence imaging is an invivo imaging method for metabolic mapping of naturally occurring fluorophores of the ocular fundus. Fundus autofluorescence imaging in agerelated macular. Schmitzvalckenberg s, jorzik j, unnebrink k, holz fg 2002 analysis of digital scanning laser ophthalmoscopy fundus autofluorescence images of geographic atrophy in. This technique allows the topographic mapping of lipofuscin distribution in the rpe. Clinical applications of fundus autofluorescence in. Jan 09, 2015 fundus autofluorescence faf is a novel noninvasive imaging technique providing invivo information on retinal status. In the setting of chorioretinal inflammation, the affected rpe monolayer shows increased metabolic activity. Interpretations of the fundus autofluorescence images fundus autofluorescence imaging is used to record fluorescence that may occur naturally in ocular structures or as a byproduct of a disease process. Automated computerassisted methods for detecting and removing interfering vessels are needed to support the ga quantification process in longitudinal studies and in reading centres.
Fundus autofluorescence imaging compared with different confocal. Introduction undus autofluorescence faf is a noninvasive imaging technique for documenting the presence of lipofuscin in the retinal pigment epithelium. Twophoton excited fluorescence microscopy of ocular. Autofluorescence imaging allows for earlier diagnosis of retinal dystrophies it provides tangible, visible evidence of disease progression, where before there was only guesswork. Hereby, faf imaging gives additional information above and beyond conventional imaging tools. Optimized filters for fundus autofluorescence imaging. Over the past decade, fundus autofluorescence imaging has become a commonly used diagnostic technique to document the presence of fluorescent structures in the eye. This article is from september 2012 and may contain outdated material. Increased fundus autofluorescence is observed with aging but also in pathologic conditions whereas decreased autofluorescence is noted in rpe atrophy andor due to signal attenuation from other pigments 28, 29. Research article open access retromode imaging and fundus.
Monitoring of atrophic progression over time with fundus autofluorescence imaging, showing the natural course of the disease over time. Quantitative fundus autofluorescence and optical coherence tomography in best vitelliform macular dystrophy. During recent years, faf fundus autofluorescence imaging has been shown to be useful in various retinal diseases with regard to diagnostics, documentation of changes, identification of disease progression, and monitoring of novel therapies. Quantitative fundus autofluorescence for the evaluation of. Application of ratiometry to fundus autofluorescence imaging. The retinal photoreceptors contain lightsensing molecules, a class of retinoids that are susceptible to damage and crosslinking, said richard f.
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