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Frederick W. Fitzke - One of the best experts on this subject based on the ideXlab platform.
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Abnormalities of fundus Autofluorescence in central serous retinopathy.
American journal of ophthalmology, 2002Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Joseph Fan, Anthony Halfyard, A C BirdAbstract:Abstract PURPOSE: To report abnormalities of fundus Autofluorescence associated with acute and chronic central serous retinopathy (CSR). DESIGN: A prospective cohort study of patients with CSR was undertaken in which the intensity and spatial distribution of fundus Autofluorescence were documented. METHODS: Fundus Autofluorescence was recorded using a confocal laser scanning ophthalmoscope (cLSO) and the images compared with the fundus appearance and fluorescein angiograms in 69 eyes of 63 subjects with either acute or chronic CSR. Areas of increased and decreased Autofluorescence were compared with ophthalmoscopic and fluorescein angiography abnormalities. Thirty patients with focal leakage on angiography and serous retinal detachment or pigment epithelial detachment were designated as having acute CSR. Thirty-three patients with diffuse leakage on fluorescein angiography, but without manifest detachment were classified as having chronic CSR. RESULTS: The mean age was 39 years (range 29–56 years) 14 were female and 49 male. Acute CSR of more than 4 months duration showed a mild diffuse increase in Autofluorescence that corresponded with the detached area. The leaking point on the angiogram corresponded to a focal area of intense Autofluorescence. In chronic CSR the Autofluorescence was very irregular, there being regions with greater and less than the background levels of fluorescence. CONCLUSION: In acute CSR, increased Autofluorescence may occur at the site of leakage and in the area of retinal detachment probably indicating an increased metabolic activity of the retinal pigment epithelium (RPE). Decreased or absent Autofluorescence in long-standing lesions may indicate reduced metabolic activity of the RPE due to photoreceptor cell loss. Documenting photoreceptor cell loss with Autofluorescence imaging may be useful in identifying patients who would not benefit from laser photocoagulation.
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Quantitative evaluation of fundus Autofluorescence imaged "in vivo" in eyes with retinal disease
The British journal of ophthalmology, 2000Co-Authors: Noemi Lois, Anthony Halfyard, Alan C Bird, Frederick W. FitzkeAbstract:AIM To describe a new method of evaluating the topographic distribution of fundus Autofluorescence in eyes with retinal disease. METHODS Images of fundus Autofluorescence were obtained in five patients and 34 normal volunteers using a confocal scanning laser ophthalmoscope (cSLO). To evaluate the topographic distribution of fundus Autofluorescence throughout the posterior pole a rectangular box, 10 × 750 pixels, was used as the area of analysis. The box was placed, horizontally, across the macular region. The intensity of fundus Autofluorescence of each pixel within the rectangular box was plotted against its degree of eccentricity. Profiles of fundus Autofluorescence from patients were compared with those obtained from the age matched control group and with cSLO images. RESULTS Profiles of fundus Autofluorescence appeared to represent the topographic distribution of fundus Autofluorescence throughout the posterior pole appreciated in the cSLO images, and allowed rapid identification and quantification of areas of increased or decreased fundus Autofluorescence. CONCLUSIONS Fundus Autofluorescence profiles appear to be useful to study the spatial distribution of fundus Autofluorescence in eyes with retinal disease.
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Distribution of pigment epithelium Autofluorescence in retinal disease state recorded in vivo and its change over time.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 1999Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:· Background: Recently a technique of imaging the retinal pigment epithelium (RPE) has been developed that takes advantages of its intrinsic fluorescence derived from lipofuscin. The purpose of this study was to document the distribution of fundus Autofluorescence in patients with various retinal diseases and its change over time. · Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 318 eyes from 159 patients with various retinal diseases using a confocal Laser Scanning Ophthalmoscope. Thirty patients with macular dystrophies and 30 with age-related macular disease underwent serial examinations over a period of 1–3 years in order to monitor the changes over time of fundus Autofluorescence. · Results: Absent Autofluorescence corresponded well spatially with outer retinal atrophy in eyes with retinitis pigmentosa and rod-cone dystrophy. Abnormally high background Autofluorescence was seen in the macular region in some patients with dominant and recessive retinitis pigmentosa and rod-cone dystrophies. In areas of macular edema fundus Autofluorescence was abnormal. Fundus Autofluorescence showed changes over time in most of the eyes with retinal diseases studied. · Conclusion: Fundus Autofluorescence allows documentation of areas of photoreceptor cell loss in eyes with retinitis pigmentosa and rod-cone dystrophies. If abnormal high background Autofluorescence in the surviving areas occurs only in some patients with retinitis pigmentosa, the technique may serve to distinguish the regional from the diffuse type of disease. Over time, fundus Autofluorescence may demonstrate change or may remain stable.
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In Vivo Fundus Autofluorescence in Macular Dystrophies
Archives of ophthalmology (Chicago Ill. : 1960), 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Objective: To document the deviation from normal of fundus Autofluorescence in patients with inherited macular dystrophies. Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 118 patients with inherited macular dystrophies by means of a confocal laser scanning ophthalmoscope, and the images were compared with the fundus appearance and fluorescein angiograms. Results: Background Autofluorescence appears to be elevated in all forms of macular dystrophies examined. The pale deposits at the level of the retinal pigment epithelium in disorders such as Best disease, adult vitelliform macular dystrophy, and fundus flavimaculatus were consistently associated with higher levels of Autofluorescence than the background signal. There was no strong correlation between the intensity of Autofluorescence and the fluorescein angiographic sign of a dark choroid. Increased levels of Autofluorescence were present in a subject with a mutation known to cause macular dystrophy but in whom there were no manifest ophthalmoscopic or functional abnormalities. Conclusions: All dystrophies examined have in common accumulation of autofluorescent material in the retinal pigment epithelium to a greater degree than that seen with age. The abnormal high background Autofluorescence associated with inherited macular dystrophies confirms the impression derived from histological studies that these disorders affect the entire retinal pigment epithelium. The lack of correlation between Autofluorescence and the presence of a dark choroid implies that there may be different fluorophores in different disorders. The pale deposits at the level of the retinal pigment epithelium—Bruch membrane seen in macular dystrophies have similar Autofluorescence characteristics. This technique may be useful in detecting the abnormal phenotype in early disease.
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fundus Autofluorescence in age related macular disease imaged with a laser scanning ophthalmoscope
Investigative Ophthalmology & Visual Science, 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Purpose. To image and quantify the spatial distribution of fundus Autofluorescence in normal subjects, to determine its age dependence, and to document the deviation from normal in patients with age-related macular disease. Methods. Using a confocal laser scanning ophthalmoscope (cLSO), the intensity and spatial distribution of fundus Autofluorescence was studied in 33 normal subjects, 97 eyes with drusen only, and 111 eyes with visual loss caused by age-related macular disease. Results. Fundus Autofluorescence intensity in normal subjects was highest at the posterior pole and dipped at the fovea. Autofluorescence increased with age at the posterior pole. Fundus in eyes with age-related maculopathy showed localized high Autofluorescence that did not correspond with drusen. Linear pigmentation at the level of the retinal pigment epithelium (RPE), whether detached or flat, fluoresced brightly, whereas plaques of melanin did not. Areas of low and high levels of Autofluorescence were seen in lesions containing choroidal new vessels. In areas of geographic atrophy, Autofluorescence was low. Conclusions. The spatial distribution of background hindus Autofluorescence and the correlation of Autofluorescence with age in normal subjects imply that Autofluorescence is derived from lipofuscin at the level of the RPE. Focal accumulation of autofluorescent material occurs at the level of the RPE in patients with drusen, but the drusen do not show marked increases in Autofluorescence. It is likely that melanolipofuscin accounts for the high levels of Autofluorescence, corresponding to linear pigmentation at the level of the RPE. Low-intensity Autofluorescence occurs in the presence of retinal photoreceptor loss, and variable levels over disciform lesions probably relate to variations in metabolic activity of the RPE.
Alan C Bird - One of the best experts on this subject based on the ideXlab platform.
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atlas of fundus Autofluorescence imaging
2007Co-Authors: Frank G. Holz, Alan C Bird, Richard F Spaide, Steffen SchmitzvalckenbergAbstract:Methodology.- Lipofuscin of the Retinal Pigment Epithelium.- Origin of Fundus Autofluorescence.- Fundus Autofluorescence Imaging with the Confocal Scanning Laser Ophthalmoscope.- How To Obtain the Optimal Fundus Autofluorescence Image with the Confocal Scanning Laser Ophthalmoscope.- Autofluorescence Imaging with the Fundus Camera.- Macular Pigment Measurement-Theoretical Background.- Macular Pigment Measurement -Clinical Applications.- Evaluation of Fundus Autofluorescence Images.- Clinical Application.- Macular and Retinal Dystrophies.- Discrete Lines of Increased Fundus Autofluorescence in Various Forms of Retinal Dystrophies.- Age-Related Macular Degeneration I-Early Manifestation.- Age-Related Macular Degeneration II-Geographic Atrophy.- Age-Related Macular Degeneration III-Pigment Epithelium Detachment.- Age-Related Macular Degeneration IV-Choroidal Neovascularization (CNV).- Idiopathic Macular Telangiectasia.- Chorioretinal Inflammatory Disorders.- Autofluorescence from the Outer Retina and Subretinal Space.- Miscellaneous.- Perspectives in Imaging Technologies.- Perspectives in Imaging Technologies.
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Quantitative evaluation of fundus Autofluorescence imaged "in vivo" in eyes with retinal disease
The British journal of ophthalmology, 2000Co-Authors: Noemi Lois, Anthony Halfyard, Alan C Bird, Frederick W. FitzkeAbstract:AIM To describe a new method of evaluating the topographic distribution of fundus Autofluorescence in eyes with retinal disease. METHODS Images of fundus Autofluorescence were obtained in five patients and 34 normal volunteers using a confocal scanning laser ophthalmoscope (cSLO). To evaluate the topographic distribution of fundus Autofluorescence throughout the posterior pole a rectangular box, 10 × 750 pixels, was used as the area of analysis. The box was placed, horizontally, across the macular region. The intensity of fundus Autofluorescence of each pixel within the rectangular box was plotted against its degree of eccentricity. Profiles of fundus Autofluorescence from patients were compared with those obtained from the age matched control group and with cSLO images. RESULTS Profiles of fundus Autofluorescence appeared to represent the topographic distribution of fundus Autofluorescence throughout the posterior pole appreciated in the cSLO images, and allowed rapid identification and quantification of areas of increased or decreased fundus Autofluorescence. CONCLUSIONS Fundus Autofluorescence profiles appear to be useful to study the spatial distribution of fundus Autofluorescence in eyes with retinal disease.
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Distribution of pigment epithelium Autofluorescence in retinal disease state recorded in vivo and its change over time.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 1999Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:· Background: Recently a technique of imaging the retinal pigment epithelium (RPE) has been developed that takes advantages of its intrinsic fluorescence derived from lipofuscin. The purpose of this study was to document the distribution of fundus Autofluorescence in patients with various retinal diseases and its change over time. · Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 318 eyes from 159 patients with various retinal diseases using a confocal Laser Scanning Ophthalmoscope. Thirty patients with macular dystrophies and 30 with age-related macular disease underwent serial examinations over a period of 1–3 years in order to monitor the changes over time of fundus Autofluorescence. · Results: Absent Autofluorescence corresponded well spatially with outer retinal atrophy in eyes with retinitis pigmentosa and rod-cone dystrophy. Abnormally high background Autofluorescence was seen in the macular region in some patients with dominant and recessive retinitis pigmentosa and rod-cone dystrophies. In areas of macular edema fundus Autofluorescence was abnormal. Fundus Autofluorescence showed changes over time in most of the eyes with retinal diseases studied. · Conclusion: Fundus Autofluorescence allows documentation of areas of photoreceptor cell loss in eyes with retinitis pigmentosa and rod-cone dystrophies. If abnormal high background Autofluorescence in the surviving areas occurs only in some patients with retinitis pigmentosa, the technique may serve to distinguish the regional from the diffuse type of disease. Over time, fundus Autofluorescence may demonstrate change or may remain stable.
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In Vivo Fundus Autofluorescence in Macular Dystrophies
Archives of ophthalmology (Chicago Ill. : 1960), 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Objective: To document the deviation from normal of fundus Autofluorescence in patients with inherited macular dystrophies. Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 118 patients with inherited macular dystrophies by means of a confocal laser scanning ophthalmoscope, and the images were compared with the fundus appearance and fluorescein angiograms. Results: Background Autofluorescence appears to be elevated in all forms of macular dystrophies examined. The pale deposits at the level of the retinal pigment epithelium in disorders such as Best disease, adult vitelliform macular dystrophy, and fundus flavimaculatus were consistently associated with higher levels of Autofluorescence than the background signal. There was no strong correlation between the intensity of Autofluorescence and the fluorescein angiographic sign of a dark choroid. Increased levels of Autofluorescence were present in a subject with a mutation known to cause macular dystrophy but in whom there were no manifest ophthalmoscopic or functional abnormalities. Conclusions: All dystrophies examined have in common accumulation of autofluorescent material in the retinal pigment epithelium to a greater degree than that seen with age. The abnormal high background Autofluorescence associated with inherited macular dystrophies confirms the impression derived from histological studies that these disorders affect the entire retinal pigment epithelium. The lack of correlation between Autofluorescence and the presence of a dark choroid implies that there may be different fluorophores in different disorders. The pale deposits at the level of the retinal pigment epithelium—Bruch membrane seen in macular dystrophies have similar Autofluorescence characteristics. This technique may be useful in detecting the abnormal phenotype in early disease.
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fundus Autofluorescence in age related macular disease imaged with a laser scanning ophthalmoscope
Investigative Ophthalmology & Visual Science, 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Purpose. To image and quantify the spatial distribution of fundus Autofluorescence in normal subjects, to determine its age dependence, and to document the deviation from normal in patients with age-related macular disease. Methods. Using a confocal laser scanning ophthalmoscope (cLSO), the intensity and spatial distribution of fundus Autofluorescence was studied in 33 normal subjects, 97 eyes with drusen only, and 111 eyes with visual loss caused by age-related macular disease. Results. Fundus Autofluorescence intensity in normal subjects was highest at the posterior pole and dipped at the fovea. Autofluorescence increased with age at the posterior pole. Fundus in eyes with age-related maculopathy showed localized high Autofluorescence that did not correspond with drusen. Linear pigmentation at the level of the retinal pigment epithelium (RPE), whether detached or flat, fluoresced brightly, whereas plaques of melanin did not. Areas of low and high levels of Autofluorescence were seen in lesions containing choroidal new vessels. In areas of geographic atrophy, Autofluorescence was low. Conclusions. The spatial distribution of background hindus Autofluorescence and the correlation of Autofluorescence with age in normal subjects imply that Autofluorescence is derived from lipofuscin at the level of the RPE. Focal accumulation of autofluorescent material occurs at the level of the RPE in patients with drusen, but the drusen do not show marked increases in Autofluorescence. It is likely that melanolipofuscin accounts for the high levels of Autofluorescence, corresponding to linear pigmentation at the level of the RPE. Low-intensity Autofluorescence occurs in the presence of retinal photoreceptor loss, and variable levels over disciform lesions probably relate to variations in metabolic activity of the RPE.
Richard F Spaide - One of the best experts on this subject based on the ideXlab platform.
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retinal pigment epithelial cell loss assessed by fundus Autofluorescence imaging in neovascular age related macular degeneration
Ophthalmology, 2013Co-Authors: Nishant Kumar, Sarah Mrejen, Adrian T Fung, Marcela Marsiglia, Boon K Loh, Richard F SpaideAbstract:Purpose To characterize retinal pigment epithelial (RPE) cell loss as evidenced by Autofluorescence imaging in patients with neovascular age-related macular degeneration (AMD). Design Retrospective cohort study. Participants There were 162 eyes of 116 consecutive patients with neovascular AMD examined in a retinal practice. Methods Each patient underwent a complete examination including Autofluorescence imaging. Areas of confluent absence of Autofluorescence signal of at least 0.5 mm in greatest linear diameter were measured within the macular area. Patient demographic and examination data were evaluated in relation to the Autofluorescence data. Main Outcome Measures Prevalence and progression of confluent areas of absent Autofluorescence and the relationship these areas had with visual acuity. Results The mean age of the patients was 82.9 years, and the mean visual acuity was 20/71 (logarithm minimum angle of resolution [logMAR], 0.55). Confluent loss of Autofluorescence was seen in 58.6% of eyes at baseline, and the median area of absent Autofluorescence among those was 1.57 mm 2 (interquartile range [IQR], 0.62–4.32 mm 2 ). Using generalized estimation equation modeling, the significant predictors for area of confluent absent Autofluorescence at baseline were duration of disease and any previous treatment with photodynamic therapy. The significant predictor of baseline visual acuity was baseline area of confluent absent Autofluorescence. Follow-up was available for 124 (76.5%) eyes, with a mean follow-up of 2.9 years. By then, the mean visual acuity was 20/90 (logMAR, 0.65), and 79% of eyes had confluent areas of absent Autofluorescence, the large majority of which affected the central macula. The median area of absent Autofluorescence was 3.61 mm 2 (IQR, 1.16–7.11 mm 2 ). The best predictor of final visual acuity was the area of absent Autofluorescence at the final follow-up. Conclusions Confluent absence of Autofluorescence, a measure signifying RPE loss, was a significant predictor of visual acuity both at baseline and at final follow-up. This is the first study to document the prevalence, rate of progression, and factors associated with measures of confluent RPE loss in patients with neovascular AMD. Application of strategies to limit RPE cell loss may prove useful in eyes with neovascular AMD. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
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atlas of fundus Autofluorescence imaging
2007Co-Authors: Frank G. Holz, Alan C Bird, Richard F Spaide, Steffen SchmitzvalckenbergAbstract:Methodology.- Lipofuscin of the Retinal Pigment Epithelium.- Origin of Fundus Autofluorescence.- Fundus Autofluorescence Imaging with the Confocal Scanning Laser Ophthalmoscope.- How To Obtain the Optimal Fundus Autofluorescence Image with the Confocal Scanning Laser Ophthalmoscope.- Autofluorescence Imaging with the Fundus Camera.- Macular Pigment Measurement-Theoretical Background.- Macular Pigment Measurement -Clinical Applications.- Evaluation of Fundus Autofluorescence Images.- Clinical Application.- Macular and Retinal Dystrophies.- Discrete Lines of Increased Fundus Autofluorescence in Various Forms of Retinal Dystrophies.- Age-Related Macular Degeneration I-Early Manifestation.- Age-Related Macular Degeneration II-Geographic Atrophy.- Age-Related Macular Degeneration III-Pigment Epithelium Detachment.- Age-Related Macular Degeneration IV-Choroidal Neovascularization (CNV).- Idiopathic Macular Telangiectasia.- Chorioretinal Inflammatory Disorders.- Autofluorescence from the Outer Retina and Subretinal Space.- Miscellaneous.- Perspectives in Imaging Technologies.- Perspectives in Imaging Technologies.
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Fundus Autofluorescence and Central Serous Chorioretinopathy
Ophthalmology, 2005Co-Authors: Richard F Spaide, James M. KlancnikAbstract:Purpose To investigate the Autofluorescence characteristics in patients with central serous chorioretinopathy. Design Observational case series. Participants Thirty consecutive patients examined in a private referral practice. Methods Patients were imaged with Autofluorescence photography, fundus photography, fluorescein angiography, and optical coherence tomography (OCT). The mean and standard deviation (SD) of the grayscale values from a 100-pixel-diameter circle centered on the fovea were obtained and normalized with the level of Autofluorescence of the posterior pole. Results There were 30 patients, 23 male (76.7%) and 7 female (23.3%), with a median visual acuity (VA) of 20/25 and a range of 20/15 to 20/400. Stepwise linear regression that included individual fixed effects found that normalized central macular Autofluorescence ( P P = 0.045), subfoveal fluid detected by OCT ( P = 0.033), and the SD of the central macular Autofluorescence ( P = 0.025) produced a highly significant model ( R 2 = 0.92, P ≪0.001) predicting VA. Increasing levels of Autofluorescence were correlated with accumulation of material on the outer surface of the retina as seen by OCT. Decreased central macular Autofluorescence, particularly in those eyes with central geographic retinal pigment epithelial atrophy, was associated with poor VA. Conclusions This study established that Autofluorescence changes occurring in central serous chorioretinopathy with explicit patterns can be measured in a noninvasive manner, and this information can be used to estimate the damage induced by central serous chorioretinopathy with a high degree of statistical significance. We hypothesize that the material on the outer surface of the elevated retina may represent accumulation of photoreceptor outer segments secondary to the lack of direct apposition and phagocytosis by the retinal pigment epithelium.
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Fundus Autofluorescence and age-related macular degeneration.
Ophthalmology, 2003Co-Authors: Richard F SpaideAbstract:Abstract Purpose To evaluate the Autofluorescence images of patients with nonexudative and the fellow eyes with exudative age-related macular degeneration (AMD). Design Observational case series. Participants Fifty-four patients seen in the author's practice. Methods A fundus camera–based system for Autofluorescence photographs was used, and the wavelengths for the excitation (580 nm) and barrier (695 nm) filters were based on known transmission and autofluorescent characteristics of the ocular media. Patients were also photographed with red-free and infrared monochromatic imaging. The mean levels of Autofluorescence were compared between patients without (group 1) and those with exudative AMD. Comparisons were made among patients with exudative AMD, examining the Autofluorescence pattern in those without retinal vascular contribution to the exudative process (group 2) to those with retinal vascular contribution (group 3). Main outcome measures Mean amounts and patterns of Autofluorescence. Results A total of 54 patients was evaluated; 18 were in each group. The mean age was 75.4 years, and there was no difference in the mean ages among the groups ( P = 0.16). There was no correlation of the Autofluorescence measurements and the degree of nuclear sclerosis ( P = 0.14). Patients with exudative AMD had more Autofluorescence in the fellow eye than did eyes of patients without exudative AMD ( P = 0.002). Patients in group 3 were more likely to have focal hyperpigmentation, particularly as imaged by infrared light ( P = 0.015), and focal areas of intense Autofluorescence ( P = 0.001) than were patients in group 2. Conclusions By use of this method of Autofluorescence imaging, it was determined that the fellow eyes of patients with exudative AMD had larger amounts of Autofluorescence than did the eyes of patients without a history of exudative AMD. Patients with retinal vascular anastomosis to the vascular proliferation of exudative AMD were much more likely to have focal areas of intense Autofluorescence in their fellow eye that corresponded, for the most part, with focal areas of hyperpigmentation best seen by infrared monochromatic fundus photography. Because the amount of fluorescence is directly related to the amount of lipofuscin, which in turn is related to the cumulative amount of oxidative damage, these findings suggest possible explanations for certain patterns of vessel growth seen in exudative AMD.
Andrea Von Rückmann - One of the best experts on this subject based on the ideXlab platform.
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Abnormalities of fundus Autofluorescence in central serous retinopathy.
American journal of ophthalmology, 2002Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Joseph Fan, Anthony Halfyard, A C BirdAbstract:Abstract PURPOSE: To report abnormalities of fundus Autofluorescence associated with acute and chronic central serous retinopathy (CSR). DESIGN: A prospective cohort study of patients with CSR was undertaken in which the intensity and spatial distribution of fundus Autofluorescence were documented. METHODS: Fundus Autofluorescence was recorded using a confocal laser scanning ophthalmoscope (cLSO) and the images compared with the fundus appearance and fluorescein angiograms in 69 eyes of 63 subjects with either acute or chronic CSR. Areas of increased and decreased Autofluorescence were compared with ophthalmoscopic and fluorescein angiography abnormalities. Thirty patients with focal leakage on angiography and serous retinal detachment or pigment epithelial detachment were designated as having acute CSR. Thirty-three patients with diffuse leakage on fluorescein angiography, but without manifest detachment were classified as having chronic CSR. RESULTS: The mean age was 39 years (range 29–56 years) 14 were female and 49 male. Acute CSR of more than 4 months duration showed a mild diffuse increase in Autofluorescence that corresponded with the detached area. The leaking point on the angiogram corresponded to a focal area of intense Autofluorescence. In chronic CSR the Autofluorescence was very irregular, there being regions with greater and less than the background levels of fluorescence. CONCLUSION: In acute CSR, increased Autofluorescence may occur at the site of leakage and in the area of retinal detachment probably indicating an increased metabolic activity of the retinal pigment epithelium (RPE). Decreased or absent Autofluorescence in long-standing lesions may indicate reduced metabolic activity of the RPE due to photoreceptor cell loss. Documenting photoreceptor cell loss with Autofluorescence imaging may be useful in identifying patients who would not benefit from laser photocoagulation.
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Distribution of pigment epithelium Autofluorescence in retinal disease state recorded in vivo and its change over time.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 1999Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:· Background: Recently a technique of imaging the retinal pigment epithelium (RPE) has been developed that takes advantages of its intrinsic fluorescence derived from lipofuscin. The purpose of this study was to document the distribution of fundus Autofluorescence in patients with various retinal diseases and its change over time. · Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 318 eyes from 159 patients with various retinal diseases using a confocal Laser Scanning Ophthalmoscope. Thirty patients with macular dystrophies and 30 with age-related macular disease underwent serial examinations over a period of 1–3 years in order to monitor the changes over time of fundus Autofluorescence. · Results: Absent Autofluorescence corresponded well spatially with outer retinal atrophy in eyes with retinitis pigmentosa and rod-cone dystrophy. Abnormally high background Autofluorescence was seen in the macular region in some patients with dominant and recessive retinitis pigmentosa and rod-cone dystrophies. In areas of macular edema fundus Autofluorescence was abnormal. Fundus Autofluorescence showed changes over time in most of the eyes with retinal diseases studied. · Conclusion: Fundus Autofluorescence allows documentation of areas of photoreceptor cell loss in eyes with retinitis pigmentosa and rod-cone dystrophies. If abnormal high background Autofluorescence in the surviving areas occurs only in some patients with retinitis pigmentosa, the technique may serve to distinguish the regional from the diffuse type of disease. Over time, fundus Autofluorescence may demonstrate change or may remain stable.
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In Vivo Fundus Autofluorescence in Macular Dystrophies
Archives of ophthalmology (Chicago Ill. : 1960), 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Objective: To document the deviation from normal of fundus Autofluorescence in patients with inherited macular dystrophies. Methods: The intensity and spatial distribution of fundus Autofluorescence was documented in 118 patients with inherited macular dystrophies by means of a confocal laser scanning ophthalmoscope, and the images were compared with the fundus appearance and fluorescein angiograms. Results: Background Autofluorescence appears to be elevated in all forms of macular dystrophies examined. The pale deposits at the level of the retinal pigment epithelium in disorders such as Best disease, adult vitelliform macular dystrophy, and fundus flavimaculatus were consistently associated with higher levels of Autofluorescence than the background signal. There was no strong correlation between the intensity of Autofluorescence and the fluorescein angiographic sign of a dark choroid. Increased levels of Autofluorescence were present in a subject with a mutation known to cause macular dystrophy but in whom there were no manifest ophthalmoscopic or functional abnormalities. Conclusions: All dystrophies examined have in common accumulation of autofluorescent material in the retinal pigment epithelium to a greater degree than that seen with age. The abnormal high background Autofluorescence associated with inherited macular dystrophies confirms the impression derived from histological studies that these disorders affect the entire retinal pigment epithelium. The lack of correlation between Autofluorescence and the presence of a dark choroid implies that there may be different fluorophores in different disorders. The pale deposits at the level of the retinal pigment epithelium—Bruch membrane seen in macular dystrophies have similar Autofluorescence characteristics. This technique may be useful in detecting the abnormal phenotype in early disease.
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fundus Autofluorescence in age related macular disease imaged with a laser scanning ophthalmoscope
Investigative Ophthalmology & Visual Science, 1997Co-Authors: Andrea Von Rückmann, Frederick W. Fitzke, Alan C BirdAbstract:Purpose. To image and quantify the spatial distribution of fundus Autofluorescence in normal subjects, to determine its age dependence, and to document the deviation from normal in patients with age-related macular disease. Methods. Using a confocal laser scanning ophthalmoscope (cLSO), the intensity and spatial distribution of fundus Autofluorescence was studied in 33 normal subjects, 97 eyes with drusen only, and 111 eyes with visual loss caused by age-related macular disease. Results. Fundus Autofluorescence intensity in normal subjects was highest at the posterior pole and dipped at the fovea. Autofluorescence increased with age at the posterior pole. Fundus in eyes with age-related maculopathy showed localized high Autofluorescence that did not correspond with drusen. Linear pigmentation at the level of the retinal pigment epithelium (RPE), whether detached or flat, fluoresced brightly, whereas plaques of melanin did not. Areas of low and high levels of Autofluorescence were seen in lesions containing choroidal new vessels. In areas of geographic atrophy, Autofluorescence was low. Conclusions. The spatial distribution of background hindus Autofluorescence and the correlation of Autofluorescence with age in normal subjects imply that Autofluorescence is derived from lipofuscin at the level of the RPE. Focal accumulation of autofluorescent material occurs at the level of the RPE in patients with drusen, but the drusen do not show marked increases in Autofluorescence. It is likely that melanolipofuscin accounts for the high levels of Autofluorescence, corresponding to linear pigmentation at the level of the RPE. Low-intensity Autofluorescence occurs in the presence of retinal photoreceptor loss, and variable levels over disciform lesions probably relate to variations in metabolic activity of the RPE.
Frank G. Holz - One of the best experts on this subject based on the ideXlab platform.
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Fundus Autofluorescence and progression of age-related macular degeneration.
Survey of ophthalmology, 2009Co-Authors: Steffen Schmitz-valckenberg, Monika Fleckenstein, Hendrik P. N. Scholl, Frank G. HolzAbstract:Fundus Autofluorescence imaging is an imaging method that provides additional information compared to conventional imaging techniques. It permits to topographically map lipofuscin distribution of the retinal pigment epithelial cell monolayer. Excessive accumulation of lipofuscin granules in the lysosomal compartment of retinal pigment epithelium cells represents a common downstream pathogenetic pathway in various hereditary and complex retinal diseases including age-related macular degeneration (AMD). This comprehensive review contains an introduction in fundus Autofluorescence imaging, including basic considerations, the origin of the signal, different imaging methods, and a brief overview of fundus Autofluorescence findings in normal subjects. Furthermore, it summarizes cross-sectional and longitudinal fundus Autofluorescence findings in patients with AMD, addresses the pathophysiological significance of increased fundus Autofluorescence, and characterizes different fundus Autofluorescence phenotypes as well as fundus Autofluorescence alterations with disease progression.
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atlas of fundus Autofluorescence imaging
2007Co-Authors: Frank G. Holz, Alan C Bird, Richard F Spaide, Steffen SchmitzvalckenbergAbstract:Methodology.- Lipofuscin of the Retinal Pigment Epithelium.- Origin of Fundus Autofluorescence.- Fundus Autofluorescence Imaging with the Confocal Scanning Laser Ophthalmoscope.- How To Obtain the Optimal Fundus Autofluorescence Image with the Confocal Scanning Laser Ophthalmoscope.- Autofluorescence Imaging with the Fundus Camera.- Macular Pigment Measurement-Theoretical Background.- Macular Pigment Measurement -Clinical Applications.- Evaluation of Fundus Autofluorescence Images.- Clinical Application.- Macular and Retinal Dystrophies.- Discrete Lines of Increased Fundus Autofluorescence in Various Forms of Retinal Dystrophies.- Age-Related Macular Degeneration I-Early Manifestation.- Age-Related Macular Degeneration II-Geographic Atrophy.- Age-Related Macular Degeneration III-Pigment Epithelium Detachment.- Age-Related Macular Degeneration IV-Choroidal Neovascularization (CNV).- Idiopathic Macular Telangiectasia.- Chorioretinal Inflammatory Disorders.- Autofluorescence from the Outer Retina and Subretinal Space.- Miscellaneous.- Perspectives in Imaging Technologies.- Perspectives in Imaging Technologies.
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fundus Autofluorescence and development of geographic atrophy in age related macular degeneration
Investigative Ophthalmology & Visual Science, 2001Co-Authors: Frank G. Holz, Caren Bellman, Stephanie Staudt, Fabian Schütt, Hans E VolckerAbstract:Purpose To describe the development of new and enlargement of preexisting atrophy confined to areas with abnormally high levels of in vivo Autofluorescence in eyes with geographic atrophy (GA) associated with age-related macular degeneration (ARMD). Methods The spatial distribution and intensity of fundus Autofluorescence as well as the spread of GA and occurrence of new GA was recorded over a period of 3 years in three patients with ARMD using a confocal scanning laser ophthalmoscope. Results A diffuse irregular increased Autofluorescence at the posterior pole was recorded at baseline in the presence of unifocal or multifocal patches of geographic atrophy. Within these areas of elevated Autofluorescence, new atrophic areas developed, and existing patches of atrophy enlarged during the review period, whereas this was not observed in areas with normal background Autofluorescence. The total area of abnormal Autofluorescence also showed enlargement over time. Conclusions These preliminary findings suggest that areas of increased Autofluorescence precede the development and enlargement of outer retinal atrophy in eyes with ARMD. Because the dominant fluorophores of fundus Autofluorescence are part of lipofuscin granules of RPE cells, the observations indicate that excessive RPE lipofuscin accumulation may be of significance in the pathogenesis of GA associated with ARMD. With GA being a major cause for severe visual loss in ARMD, in vivo fundus Autofluorescence recording over time may allow identification of prognostic determinants and may give important clues to the understanding of mechanisms of disease.
