Fluorescence Lifetimes of Drusen in Age-Related Macular Degeneration

Dysli, Chantal; Fink, R.; Wolf, Sebastián; Zinkernagel, Martin S.

doi:10.1167/iovs.17-22184

Cited by 56 publications

(73 citation statements)

References 30 publications

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“…[11][12][13] Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an imaging technology supplementing the current armamentarium of multimodal retinal imaging. [14][15][16][17] Because the diagnosis of MacTel can be challenging especially at early stages of disease, FLIO may serve as an additional tool for early detection of Mac-Tel and possibly obtain information on disease progression. Because FLIO has been shown to detect changes in macular pigment with high contrast [18][19][20] changes in macular pigment specific lifetimes provide information about macular photoreceptor or possibly Müller cell loss.…”

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confidence: 99%

Fluorescence Lifetime Patterns in Macular Telangiectasia Type 2

Solberg

Dysli

Wolf

et al. 2020

Retina

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Purpose: Type 2 idiopathic macular telangiectasia (MacTel) is a rare bilateral neurodegenerative disease characterized by alterations in the macular capillary network leading to central vision loss. The purpose of this study was to quantify disease-specific retinal fluorescence lifetime patterns in patients with MacTel using fluorescence lifetime imaging ophthalmoscopy. Participants: Both eyes of 14 patients (mean age ± SEM, 67.8 ± 6.4 years) with a clinical diagnosis of MacTel Type 2 and 14 healthy age-matched controls (age 69.8 ± 6.4 years) were included in this study. Methods: All participants were imaged with a fluorescence lifetime imaging ophthalmoscope (Heidelberg Engineering, Germany). Mean retinal fluorescence lifetimes (Ƭm) were obtained in the short spectral channels (498-560 nm) and long spectral channels (560-720 nm). Clinical features, fundus images, fundus autofluorescence intensity images, spectral domain optical coherence tomography, and corresponding macular pigment optical density measurements using a modified confocal scanning laser ophthalmoscope (mpHRA) were further analyzed. Patients were classified into five phenotypic subgroups using the Gass and Blodi classification. Results: Mean fluorescence lifetimes were significantly prolonged temporal to the fovea in patients with MacTel compared with healthy controls (mean ± SEM: short spectral channels 543 ± 61 ps vs. 304 ± 9 ps; P , 0.0001; long spectral channels: 447 ± 26 ps vs. 348 ± 11 ps; P , 0.0001), and appeared as a crescent or ring-shaped pattern. Prolonged lifetime patterns correlated with decreased macular pigment density on macular pigment optical density measurements. Follow-up examinations were performed in four MacTel patients, which revealed an increase of short spectral channel Ƭ m of 22% over 2.1 years in the temporal fovea. Conclusion: This study confirms that fundus autofluorescence lifetimes display characteristic patterns in patients with MacTel Type 2 disease and provide information about macular pigment and possibly photoreceptor loss. Fluorescence lifetime prolongation correlates with disease severity and may therefore be a useful addition to other imaging modalities for assessing disease progression in MacTel Type 2.

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confidence: 99%

Fluorescence Lifetime Patterns in Macular Telangiectasia Type 2

Solberg

Dysli

Wolf

et al. 2020

Retina

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“…These sub-RPE deposits have the same spectral emission as drusen [27]. Previously Dysli et al [28] have shown that prolonged fluorescence lifetimes are displayed by drusen, while Sauer et al [19] have demonstrated, in patients with nonexudative AMD, a ring-shaped pattern of prolonged fluorescence lifetimes in the LSC, which is evident in all patients with AMD, and only in one third of healthy controls. Thus, it is possible that these findings could also contribute to the prolonged fluorescence lifetimes observed within atrophic regions in AMD.…”

Section: Discussionmentioning

confidence: 89%

Fluorescence Lifetime Patterns of Retinal Pigment Epithelium Atrophy in Patients with Stargardt Disease and Age-Related Macular Degeneration

et al. 2019

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Purpose: To investigate whether autofluorescence lifetime patterns within retinal pigment epithelium (RPE) atrophy differ between age-related macular degeneration (AMD) and Stargardt disease (STGD). Methods: Mean retinal autofluorescence lifetimes were measured in a short and a long spectral channel (SSC: 498-560 nm; LSC: 560-720 nm). Mean retinal fluorescence lifetimes were analyzed with corresponding clinical features, fundus images, fundus autofluorescence intensity images, and optical coherence tomography. Mean fluorescence lifetime values of atrophic areas were compared between the two cohorts and within the same patient to adjacent nonatrophic regions. Results: Mean fluorescence lifetimes within areas with RPE atrophy of 13 patients with STGD (mean age ± SEM 43.7 ± 5 years) and 30 patients with geographic atrophy (mean age: 78 ± 2 years) were analyzed and compared to age-matched healthy participants. The mean area of RPE atrophy in STGD and AMD was 6.6 ± 2.3 mm 2 (range: 0.66-33.17 mm 2 ) and 17.5 ± 3.8 mm 2 (range: 0.58-50.02 mm 2 ), respectively. In patients with AMD, atrophic areas revealed significantly longer mean fluorescence lifetime values as compared with patients with STGD (SSC: 997 ± 60 vs. 363 ± 26 ps; LSC: 880 ± 46 vs. 393 ± 23 ps; p < 0.0001). Conclusions: This study established that RPE atrophy in patients secondary to STGD and AMD display distinctive mean fluorescence lifetime characteristics. As retinal fluorescence lifetimes within areas of RPE atrophy were significantly longer in AMD patients, the analysis of specific lifetime patterns may provide additional insight into the disease processes and the pathogenetic mechanisms in the development of atrophic patches in AMD and STGD.

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“…[58][59][60] Fluorescence Lifetime Imaging Ophthalmoscopy Fluorescence lifetime imaging ophthalmoscopy (FLIO) is a novel noninvasive imaging modality providing in vivo measurement of the lifetimes of endogenous retinal fluorophores and is closely related to FAF. [61][62][63] When photons from an external light source are applied to excite endogenous fluorophores of the retina, the fluorophores achieve a higher level of energy before returning to their ground state, and the average time between these two events can be quantified as the fluorescence lifetime. While conventional FAF provides spatial-resolved information on fluorescence intensities, FLIO additionally measures fluorescence lifetimes; thus, providing both space and time resolution.…”

Section: Multicolor Confocal Scanning Laser Ophthalmoscopymentioning

confidence: 99%

“…[61][62][63] Studies have indicated that eyes with AMD have longer mean AF lifetimes compared with age-matched controls. Specifically, areas of complete outer retinal and RPE atrophy associated with GA have demonstrated long lifetimes likely due to fluorophore emission from the underlying choroid and connective tissue components, while eyes with RPE atrophy but remaining photoreceptor segments have displayed shorter fluorescence lifetimes.…”

Section: Multicolor Confocal Scanning Laser Ophthalmoscopymentioning

confidence: 99%