Scheimpflug photography of the anterior eye segment with densitometric image analysis to measure lens transparency has proven its value in long-term follow-up studies of lens changes. The necessary technical conditions of the SL 45 Topcon camera guarantee high reproducibility. The technical control with respect to quality in case of repeated photography is ensured by an internal standard, the camera being equipped with a five-step scale of known density values. External standardization is done by taking the densitometer height of the cornea as standard. The coefficients of variation of internal and external standards were nearly equal (approximately 5%) over the 9-month period of observation of 100 patients (3,200 photos). The coefficients of variation correspond to the standard error found with repeated lens photos of volunteers' eyes evaluated by analysis of variance of the respective data sets. The standard error for distance measurements on the x-axis (cornea thickness, depth of anterior chamber, lens thickness, etc.) is less than 3%. Evaluation of follow-up examinations may most successfully be done by densitometric planimetry, which, in case of follow-up studies on opacified lenses, is superior to the usual measurements of densitometer height. The light scatter registered by Scheimpflug photography is highly individual. This is demonstrated by densitograms of normal lenses of persons of different age groups. Besides linear densitometry, various other procedures of densitometric planimetry are possible. The best results so far were obtained by multilinear densitometry, but the enormous amount of data obtained in this way renders routine application rather difficult.
During the aging process, the lens is subjected to changes of its pertinent properties which condition the transmission of light of different wavelengths. Between the second and the third decade, for instance, wavelengths below 400 nm are almost completely absorbed. The increase in lens thickness, effected by the appositional growth during life, might be considered responsible for this phenomenon, if the newly developing lens fibers in the outer periphery would synthesize proteins which, with respect to light transmission, differ from those formed during the embryonic phase. For such a phenomenon, however, no indication was found either by clinical observations or biochemical research. -Microdensitometric analysis of Scheimpflug-photographs of the anterior eye segment allows measurements of lens transparency in the single lens which directly depend on the respective wavelengths used in the photographic procedure. Investigations performed with this method on a normal age-grouped population, show that the changes in light transmission are most evident in two of the lens segments. The lens nucleus shows a continuous increase in light scatter during aging. Also the anterior cortex - particularly in the deeper layers - shows changes in light transmission. With advancing age (beginning between 30 and 40 years of age), increased lens fluorescence is found in the region of the deeper anterior cortex, which can be excited by UV wavelengths of 330-380 nm. This phenomenon is not found in the lens nucleus. The localization of the changes within the lens clearly shows that they are due to age-related modifications of the protein properties earlier designated as posttranslational or postsynthetic molecular modifications.(ABSTRACT TRUNCATED AT 250 WORDS)
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