Autofluorescence Lifetimes in Geographic Atrophy in Patients With Age-Related Macular Degeneration

Dysli, Chantal; Wolf, Sebastian; Zinkernagel, Martin S.

doi:10.1167/iovs.15-18381

Cited by 71 publications

(91 citation statements)

References 30 publications

(32 reference statements)

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“…11 C, Dysli et al, 2016e). Local spots with prolonged lifetimes correlated with intraretinal deposits or RPE atrophy.…”

Section: Neovascular Age-related Macular Degenerationmentioning

confidence: 96%

“…On conventional fundus autofluorescence intensity images, melanin absorbs the short-wavelength excitation beam, decreasing the overall autofluorescence signal (Yung et al, 2016). FLIO measurement of pure melanin featured long values with decay times between 648 and 1600 ps (Dysli et al, 2016e).…”

Section: Fluorescence Lifetimes Of Retinal Fluorophores Ex Vivomentioning

confidence: 99%

“…(Dysli et al, 2016e) This might be a sign of early accumulation of bisretinoids in the RPE. In early stages, membranous debris from atrophic photoreceptor outer segments may not yet appear as visible in conventional imaging techniques (Khan et al, 2016) When analyzing specifically fluorescence lifetime values of soft drusen and reticular pseudodrusen as the two main forms of drusenoid deposits, a broad range of fluorescence lifetimes was detected.…”

Section: Drusen and Reticular Pseudodrusenmentioning

confidence: 99%

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Fluorescence lifetime imaging ophthalmoscopy

Dysli

Wolf

Zinkernagel

2017

Acta Ophthalmologica

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a b s t r a c tImaging techniques based on retinal autofluorescence have found broad applications in ophthalmology because they are extremely sensitive and noninvasive. Conventional fundus autofluorescence imaging measures fluorescence intensity of endogenous retinal fluorophores. It mainly derives its signal from lipofuscin at the level of the retinal pigment epithelium. Fundus autofluorescence, however, can not only be characterized by the spatial distribution of the fluorescence intensity or emission spectrum, but also by a characteristic fluorescence lifetime function. The fluorescence lifetime is the average amount of time a fluorophore remains in the excited state following excitation. Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an emerging imaging modality for in vivo measurement of lifetimes of endogenous retinal fluorophores. Recent reports in this field have contributed to our understanding of the pathophysiology of various macular and retinal diseases.Within this review, the basic concept of fluorescence lifetime imaging is provided. It includes technical background information and correlation with in vitro measurements of individual retinal metabolites. In a second part, clinical applications of fluorescence lifetime imaging and fluorescence lifetime features of selected retinal diseases such as Stargardt disease, age-related macular degeneration, choroideremia, central serous chorioretinopathy, macular holes, diabetic retinopathy, and retinal artery occlusion are discussed. Potential areas of use for fluorescence lifetime imaging ophthalmoscopy will be outlined at the end of this review.

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“…11 C, Dysli et al, 2016e). Local spots with prolonged lifetimes correlated with intraretinal deposits or RPE atrophy.…”

Section: Neovascular Age-related Macular Degenerationmentioning

confidence: 96%

Section: Fluorescence Lifetimes Of Retinal Fluorophores Ex Vivomentioning

confidence: 99%

Section: Drusen and Reticular Pseudodrusenmentioning

confidence: 99%

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Fluorescence lifetime imaging ophthalmoscopy

Dysli

Wolf

Zinkernagel

2017

Acta Ophthalmologica

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“…16 However, long lifetimes were also seen in areas with preserved retinal layer structure. These long lifetime spots corresponded to intraretinal hyperdensities in OCT, which are described as aberrant or migrated dysfunctional RPE cells or cell fragments.…”

Section: Discussionmentioning

confidence: 99%

“…2,11,12 Fluorescence lifetime imaging ophthalmoscopy (FLIO) can identify early retinal changes in degenerative retinal diseases and has been shown to provide not only information about the integrity of the RPE but of the photoreceptors as well. [13][14][15][16][17][18][19][20][21][22] FLIO measures the lifetime time span of naturally occurring retinal fluorophores on excitation with a blue laser light impulse. Fluorescence lifetimes are specific for each molecule.…”

mentioning

confidence: 99%

Fluorescence lifetimes of drusen in age‐related macular degeneration

Dysli

Fink

Wolf

et al. 2017

Acta Ophthalmologica

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PURPOSE. The purpose of this study was to characterize fundus autofluorescence lifetimes of retinal drusen in patients with AMD. METHODS.Patients with AMD and retinal drusen and healthy controls of similar age were examined. A fluorescence lifetime imaging ophthalmoscope was used. Retinal autofluorescence was excited using a 473-nm pulsed laser, and fundus autofluorescence lifetimes of the central retina (308) were measured in two distinct spectral channels (short: 498 to 560 nm [SSC]; long: 560 to 720 nm [LSC]). Mean retinal autofluorescence lifetimes, corresponding fundus autofluorescence intensity images, spectral domain optical coherence tomography, color fundus images, and clinical data were investigated. Patients were analyzed in two distinct groups (soft drusen and reticular pseudodrusen) and compared with control subjects.RESULTS. Sixty-four eyes of 64 patients with AMD and retinal drusen (age: mean 6 SD, 78 6 8.5 years; range, 59 to 94 years) were investigated and compared with a control group of 20 age-matched healthy subjects. Mean retinal autofluorescence lifetimes in patients with AMD was significantly prolonged compared with the healthy control eyes (mean 6 SEM: SSC, 486 6 18 vs. 332 6 11 ps, P < 0.0001; LSC: 493 6 9 vs. 382 6 17 ps, P < 0.0001). Areas of drusen featured a wide range of fluorescence lifetime values. Long lifetimes were identified in areas of atrophy and in areas of intraretinal hyperreflective deposits. Short lifetimes corresponded to deposits within the photoreceptor outer segment band.CONCLUSIONS. Mean retinal autofluorescence lifetimes in AMD patients are significantly prolonged. Intraretinal deposits cause prolonged lifetimes, whereas deposits in the area of the outer photoreceptor segments lead to short fluorescence lifetimes.Keywords: fluorescence lifetimes, fundus autofluorescence, retinal imaging, FLIO, age-related macular degeneration, AMD, deposits, drusen A MD is caused by age-related metabolic disorders in the retina, which leads to thickening of the Bruch membrane with calcifications, basal laminar deposits, and appearance of drusen. The predominant symptom is progressive central vision loss. The prevalence of advanced AMD is estimated to increase from 2.2% in 65-year-old patients to more than 21% in patients older than 90 years.1 Various risk factors have been identified, including age, sex, arterial hypertension, arteriosclerosis, elevated serum lipids, smoking, alcohol abuse, exposure to UV light, and various genetic factors. 2-6The hallmark of early AMD is the presence of retinal drusen, which can be classified into soft drusen of various sizes (small, medium, large), hard drusen, cuticular drusen, crystalline drusen, and reticular pseudodrusen. 4,7 In the biomicroscopic fundus examination, drusen are seen as discrete, yellow-white punctuate elevations. Retinal drusen are focal deposits of extracellular debris located between the basal lamina of the RPE and the inner collagenous layer of the Bruch membrane and are mainly concentrated within the posterior pole. The ...

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