Fundus autofluorescence in the diagnosis of cystoid macular oedema

McBain, Vikki A.; Forrester, J.V.; Lois, Noemi

doi:10.1136/bjo.2007.129957

Cited by 49 publications

(96 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Four of the studies selected patients consecutively (i.e. in the chronological order in which they first presented to clinicians) 84,97,98,100 and the remaining studies did not report whether selection was consecutive. 83,96,99,101 Retrospective studies, and those lacking consecutive patient recruitment, may be at greater risk of selection bias, and this is considered further below in relation to the overall assessment of the quality of evidence (see Quality of research available).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Although FAF imaging may be used to detect autofluorescence in a wide range of retinal diseases (see Chapter 1), the eight included studies 83,84,[96][97][98][99][100][101] cover only three broad retinal conditions. These are AMD (four studies 96,97,99,101 ) cystoid macular oedema (two studies 83,100 ) and diabetic macular oedema (two studies 84,98 ). Of four studies on AMD, three studies specifically investigated FAF imaging in the detection of reticular pseudodrusen 96,97,101 and one study investigated FAF imaging in the diagnosis of choroidal neovascularisation.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…83,84,[96][97][98][99][100][101] Full details of these studies, including our assessment of their methodological rigour, are given in the data extraction forms (see Appendix 5).…”

Section: Quantity Of Research Availablementioning

confidence: 99%

See 2 more Smart Citations

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Frampton

Kalita

Payne

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundNatural fluorescence in the eye may be increased or decreased by diseases that affect the retina. Imaging methods based on confocal scanning laser ophthalmoscopy (cSLO) can detect this ‘fundus autofluorescence’ (FAF) by illuminating the retina using a specific light ‘excitation wavelength’. FAF imaging could assist the diagnosis or monitoring of retinal conditions. However, the accuracy of the method for diagnosis or monitoring is unclear.ObjectiveTo conduct a systematic review to determine the accuracy of FAF imaging using cSLO for the diagnosis or monitoring of retinal conditions, including monitoring of response to therapy.Data sourcesElectronic bibliographic databases; scrutiny of reference lists of included studies and relevant systematic reviews; and searches of internet pages of relevant organisations, meetings and trial registries. Databases included MEDLINE, EMBASE, The Cochrane Library, Web of Science and the Medion database of diagnostic accuracy studies. Searches covered 1990 to November 2014 and were limited to the English language.Review methodsReferences were screened for relevance using prespecified inclusion criteria to capture a broad range of retinal conditions. Two reviewers assessed titles and abstracts independently. Full-text versions of relevant records were retrieved and screened by one reviewer and checked by a second. Data were extracted and critically appraised using the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS) for assessing risk of bias in test accuracy studies by one reviewer and checked by a second. At all stages any reviewer disagreement was resolved through discussion or arbitration by a third reviewer.ResultsEight primary research studies have investigated the diagnostic accuracy of FAF imaging in retinal conditions: choroidal neovascularisation (one study), reticular pseudodrusen (three studies), cystoid macular oedema (two studies) and diabetic macular oedema (two studies). Sensitivity of FAF imaging using an excitation wavelength of 488 nm was generally high (range 81–100%), but was lower (55% and 32%) in two studies using longer excitation wavelengths (514 nm and 790 nm, respectively). Specificity ranged from 34% to 100%. However, owing to limitations of the data, none of the studies provide conclusive evidence of the diagnostic accuracy of FAF imaging.LimitationsNo studies on the accuracy of FAF imaging for monitoring the progression of retinal conditions or response to therapy were identified. Owing to study heterogeneity, pooling of diagnostic outcomes in meta-analysis was not conducted. All included studies had high risk of bias. In most studies the patient spectrum was not reflective of those who would present in clinical practice and no studies adequately reported how FAF images were interpreted.ConclusionsAlthough already in use in clinical practice, it is unclear whether or not FAF imaging is accurate, and whether or not it is applied and interpreted consistently for the diagnosis and/or monitoring of retinal conditions. Well-designed prospective primary research studies, which conform to the paradigm of diagnostic test accuracy assessment, are required to investigate the accuracy of FAF imaging in diagnosis and monitoring of inherited retinal dystrophies, early age-related macular degeneration, geographic atrophy and central serous chorioretinopathy.Study registrationThis study is registered as PROSPERO CRD42014014997.FundingThe National Institute for Health Research Health Technology Assessment programme.

show abstract

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Frampton

Kalita

Payne

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…17,18 The macular pigment (MP), however, with its high concentration of lutein and zeaxanthin, absorbs blue light to a large extent and thus greatly attenuates the FAF signal from the central macula. 19,20 Given that the underlying pathological mechanisms in DMO could potentially influence MP distribution, 16 the interpretation of conventional 488 nm FAF images in patients with DMO may be difficult.…”

Section: Introductionmentioning

confidence: 99%

“…FAF imaging showed 81% sensitivity and 69% specificity in detecting cystic macular oedema of non-diabetic aetiology in a study by McBain and colleagues. 16 Most commercially available cSLOs for FAF imaging employ blue laser light with a wavelength of 488 nm for excitation. 17,18 The macular pigment (MP), however, with its high concentration of lutein and zeaxanthin, absorbs blue light to a large extent and thus greatly attenuates the FAF signal from the central macula.…”

Section: Introductionmentioning

confidence: 99%

Two-wavelength fundus autofluorescence and macular pigment optical density imaging in diabetic macular oedema

Waldstein

Hickey

Mahmud

et al. 2012

Eye

View full text Add to dashboard Cite

Purpose To evaluate the application of 488 and 514 nm fundus autofluorescence (FAF) and macular pigment optical density (MPOD) imaging in diabetic macular oedema (DMO) and to demonstrate the typical imaging features. Patients and Methods A hundred and twentyfive eyes of 71 consecutive patients with diabetic retinopathy who underwent examination at a specialist university clinic employing a modified Heidelberg Retina Angiograph, using two different light sources of 488 and 514 nm wavelength, were retrospectively reviewed. MPOD images were calculated using modified Heidelberg Eye Explorer software. All images were evaluated by two independent masked graders. Features from FAF and MPOD images were correlated with optical coherence tomography (OCT) imaging findings and inter-grader variability, sensitivity and specificity were calculated using OCT as reference. Results Sixty-seven eyes had DMO on OCT. The inter-grader variability was 0.84 for 488 nm FAF, 0.63 for 514 nm FAF and 0.79 for MPOD imaging. Sensitivity and specificity for detection of DMO were 80.6 and 89.7% for 488 nm FAF; 55.2 and 94.8% for 514 nm FAF; and 80.6 and 91.4% for MPOD imaging. In 488 nm FAF and MPOD imaging, DMO was better visualised in comparison with 514 nm FAF imaging, Po0.01. MPOD revealed displacement of macular pigment by intraretinal cysts. Conclusion MPOD imaging, and particularly its combination with 488 nm and 514 nm FAF, provides a valuable addition to OCT in the evaluation of DMO and is clinically useful in rapid en-face assessment of the central macula.

show abstract

Foveal Hypoautofluorescence: Does It Correlate to Visual Acuity in White Dot Syndromes?—Reply

Yeh¹

2010

Arch Ophthalmol

View full text Add to dashboard Cite

Fundus autofluorescence in the diagnosis of cystoid macular oedema

Abstract: AF imaging can be used as a rapid, non-invasive technique in the diagnosis of CMO.

Cited by 49 publications

References 20 publications

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Two-wavelength fundus autofluorescence and macular pigment optical density imaging in diabetic macular oedema

Foveal Hypoautofluorescence: Does It Correlate to Visual Acuity in White Dot Syndromes?—Reply

Contact Info

Product

Resources

About